to the Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (
to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration related to transitional rent services. Read what
about California's Behavioral Health Transformation.
The BH-CONNECT demonstration builds upon unprecedented investments and policy transformations currently underway in California that are designed to expand access to community-based behavioral health care and improve outcomes for Medi-Cal members living with the most significant mental health and substance use needs. The BH-CONNECT demonstration will standardize and scale evidence-based models so Medi-Cal members with the greatest needs receive upstream, field-based care delivered in the community; avoid unnecessary emergency department visits, hospitalizations, and stays in inpatient and residential facilities; reduce involvement with the justice system; and report improved status. To achieve these goals, the BH-CONNECT demonstration includes some components that will be implemented on a statewide basis and other components that will be implemented on a county opt-in basis.
To improve the well-being and health outcomes of Medi-Cal members during critical transitions or who meet high-risk criteria, DHCS is seeking an amendment to the CalAIM Section 1115 demonstration to provide up to six months of transitional rent services to eligible individuals who are homeless or at risk of homelessness and transitioning out of institutional levels of care, congregate residential settings, correctional facilities, the child welfare system, recuperative care facilities, short-term post-hospitalization housing, transitional housing, homeless shelters or interim housing, as well as those who meet the criteria for unsheltered homelessness or for a Full Service Partnership (FSP) program. Transitional rent services will be available for a period of no more than six months; must be cost-effective; and will be provided only if it is determined to be medically appropriate using clinical and other health-related social needs criteria. Transitional rent services will be voluntary for Medi-Cal managed care plans to offer and for Medi-Cal members to use.
for more information.
DHCS announced that the initial go-live date for the justice-involved initiative moved from April 1, 2024, to October 1, 2024. DHCS will also issue the final policy and operational guide for planning and implementing the CalAIM justice-involved initiative. DHCS still anticipates a two-year implementation period. This change will allow California's correctional facilities, county partners, managed care plans, and community-based organizations to better prepare for the implementation of targeted pre-release services as required by state law and authorized in California's approved CalAIM demonstration.
The change will also allow more time to finalize policy and associated IT systems modifications that are required to implement the initiative; to continue to engage with implementation partners (correctional facilities, community-based providers, and Medi-Cal managed care plans) to provide technical assistance related to policy and operational expectations; and for correctional facilities to use
grant funding to make necessary investments to demonstrate readiness and to comply with policy and operational requirements.
Additionally, DHCS is releasing the policy and operational guide for planning and implementing the CalAIM justice-involved reentry initiative. Along with the guide, DHCS will release a summary of changes made to the guide based on stakeholder feedback. Lastly, DHCS will release a draft of the correctional facility readiness assessment template for stakeholder feedback. To submit questions or comments, please send an email to
no later than November 13, 2023.
Program Updates
January 2024 Medi-Cal Managed Care Plan Transition
DHCS is
transforming Medi-Cal to ensure Californians have access to the care they need to live healthier lives. Beginning in 2024, Medi-Cal managed care plans will be subject to new requirements to rigorously advance health equity, quality, access, accountability, and transparency to improve the Medi-Cal health care delivery system. As part of this transformation, some plans are changing on January 1, which will result in approximately 1.2 million Medi-Cal managed care members having new plan options. In some cases, these changes will also require members to transition to new plans if their current plan no longer serves members in their county. Changing plans will not affect Medi-Cal coverage or benefits.
Earlier this month, members who will transition to a new plan in January 2024 received a notice from their exiting plan. DHCS prepared
Medi-Cal Eligibility Division Information Letter Number I 23-54 to provide counties with information about some Medi-Cal members' change to a new plan on January 1 and the resources available to support their transition. DHCS also prepared the
2024 Managed Care Plan Transition Policy Guide that includes specific requirements for plans.
DHCS produced additional resources to support members, providers, and other stakeholders with the transition. These resources are valuable to county eligibility workers, plans, providers, and other stakeholders who are answering transition questions from members. The resources include the
Managed Care Plan Transition Member webpage with a county “look-up" tool, member notices, frequently asked questions, and a
Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for
providers and
plans and other stakeholders. Please send an email with questions or comments to
MCPTransitionPolicyGuide@dhcs.ca.gov.
CalSAWS System Migration
On October 30, the final wave of California Statewide Automated Welfare System (CalSAWS) migration is scheduled for completion. California's 58 counties are currently split among two eligibility and enrollment systems: California Work Opportunity and Responsibility to Kids Information Network (CalWIN) and CalSAWS. In 2016, CMS and Food and Nutrition Service (FNS) required California to implement a single county system (CalSAWS) by December 31, 2023, to support all 58 counties.
The CalWIN counties' migration to CalSAWS was organized in six waves, starting in October 2022. All 58 counties will now operate on CalSAWS. In addition to the CalWIN to CalSAWS migration, the public-facing portals to apply for benefits have merged into one portal (
BenefitsCal). Applicants and members in all counties will now use BenefitsCal to apply for and manage Medi-Cal, CalFresh, and CalWORKs benefits.
Reject Code 80 (Diagnosis) Implementation Date Postponed
On October 17, DHCS issued a
bulletin announcing the postponement of Reject Code 80, Diagnosis Code Submitted Does Not Meet Drug Coverage Criteria, as part of Phase IV, Lift 4 of Reinstatement on November 10, 2023, for members 22 years of age and older. Medi-Cal Rx will issue another bulletin once the implementation date is determined. Based upon stakeholder feedback, the decision was made to postpone the implementation to reduce disruption and ensure safe and timely delivery of pharmacy benefits.
Join Our Team
DHCS is hiring for our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the
CalCareers website.
DHCS' purpose is to provide equitable access to quality health care leading to a healthy California for all. DHCS' goals and objectives reflect DHCS' tremendous work to transform the state's health care system and strengthen organizational excellence.
Upcoming Stakeholder Meetings and Webinars
Providing Access and Transforming Health (PATH) Justice-Involved Program Office Hours
On October 23, DHCS will host the next
PATH Justice-Involved Program virtual office hours session for Round 3 awardees (advance registration required). Office hours will be held every other Monday at 11:30 a.m. through December 18 to assist Round 3 agencies, including supporting implementation plan submission. For more information, visit the
Justice-Involved Program website.
Minor Consent and Confidentiality for Sexual Health Services Webinar
On October 25, from 12 to 1:30 p.m., DHCS and the California Prevention Training Center will host a
Minor Consent and Confidentiality for Sexual Health Services webinar (advanced registration required).
This webinar will provide an overview of the California laws that impact minors and their access to confidential sexual health and family planning services. It will review important exceptions to confidentiality, including mandated child abuse reporting, and share some examples of best practices for implementation in difficult situations. Participants will learn about resources to support implementation of minor consent laws and be given an opportunity to test their own knowledge through case studies. For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be made available on the
Family PACT website.
Providing Access and Transforming Health (PATH) Collaborative Planning and Implementation (CPI) Best Practices Webinar
On October 27, from 10 to 11 a.m., DHCS will host a statewide webinar, entitled
Enhanced Care Management (ECM) and Community Supports Provider Peer Support and Contracting Self-Assessment (advance registration required). This virtual session is the first in a series of biannual best practices webinars designed to highlight best practices for implementing ECM and Community Supports, increase providers' successful participation in CalAIM, and improve collaboration with managed care plans, state and local government agencies, and other stakeholders to build and deliver quality support services to Medi-Cal members. For more information and to register, please visit the
PATH CPI webpage.
Behavioral Health Continuum Infrastructure Program (BHCIP) Listening Session
On October 30, DHCS will host a
BHCIP listening session open to the public, including counties, tribal entities, and nonprofit and for-profit organizations. The listening session will provide a program update on BHCIP Round 6, Part I: Unmet Needs and allow eligible applicants to provide input on planning and implementation. This remaining BHCIP round of funding will be divided into two parts and totals $480.7 million. For Round 6, Part I, a program update is anticipated to be issued in November, followed by a Request for Application (RFA) in January 2024. Round 6, Part II may follow the same timeframe in November 2025-January 2026.
BHCIP provides DHCS with funding to award a total of $2.2 billion through six rounds of competitive grants to qualified entities to construct, acquire, and rehabilitate real estate assets, or to invest in mobile crisis infrastructure, to expand the community continuum of behavioral health treatment resources. Please email any questions to
BHCIP@dhcs.ca.gov.
Children and Youth Behavioral Health Initiative (CYBHI) All-Payer Fee Schedule
On October 30, DHCS, in collaboration with the Department of Managed Health Care (DMHC), will virtually hold a
workgroup session to inform the development of the statewide all-payer fee schedule for school-based behavioral health services under the CYBHI. Through this workgroup, DHCS and DMHC will engage partners representing K-12 education, institutions of higher education, Medi-Cal managed care plans, commercial health plans, county behavioral health departments, behavioral health providers, associations, advocates, youth, and parents/caregivers on a variety of policy and operational topics to help inform the development and refinement of the program design.
The fee schedule will include a set of medically necessary outpatient mental health or substance use disorder treatment provided to a student 25 years of age or younger, at a school site or near a school site, and the development of a school-linked statewide provider network of school site behavioral health counselors.
CalAIM Data Sharing Authorization Guidance (DSAG) 2.0 Webinar
On October 30 at 10:30 a.m., DHCS will host an
all-comer webinar on the updated CalAIM DSAG 2.0 (advanced registration is required). This document was created to provide guidance on data sharing under the CalAIM provisions of Assembly Bill (AB) 133, a 2021 law that makes it easier for a wide range of providers to share data for the purposes of implementing CalAIM. The webinar will include an overview of the CalAIM DSAG; key privacy laws applicable to CalAIM to help Medi-Cal partners understand applicable privacy and consent laws across four key areas of data privacy; AB 133's data sharing provisions and related guidance; consent and authorizations; and data sharing use case scenario examples.
All Medi-Cal managed care plans, tribal health programs, health care providers, community-based social and human service organizations and providers, local health jurisdictions, correctional facility health care providers, and county and other public agencies that provide services and manage care for individuals enrolled in Medi-Cal are invited to attend.
Medi-Cal Children's Health Advisory Panel (MCHAP) Meeting
On November 2, DHCS will host the next MCHAP hybrid meeting (advance registration required) at The California Endowment (1414 K Street, Sacramento). Meeting materials will be posted on the
MCHAP webpage closer to the meeting date. If you are interested in receiving information about meetings or have general inquiries, please email
MCHAP@dhcs.ca.gov.
