that the Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule program, a first-of-its kind multi-payer effort to reimburse local educational agencies (LEA), which are school districts and county offices of education, and public institutions of higher education (IHE) for behavioral health supports provided to students, has already demonstrated positive results.
As of October 15, 2025, the CYBHI Fee Schedule program has enrolled more than 500 LEAs and IHEs and reimbursed more than $1.8 million for more than 26,000 service claims. Also, more than 5,000 students have received services submitted for reimbursement. Additionally, 55 LEAs and IHEs have submitted claims through the program, representing 32 managed care plans and other insurers. These early outcomes reflect significant progress achieved in less than two years since the Fee Schedule program launched, and just more than a year since participants first became eligible to bill for services.
To increase use of the Fee Schedule program, DHCS released the
CYBHI Fee Schedule Program Guidance for LEAs and IHEs, offering comprehensive guidance for providers to participate, and rolled out a public awareness campaign for parents and caregivers about the program and how students may benefit. Visit the
CYBHI Fee Schedule website to learn more.
Program Updates
Now Open: Managed Care Enrollment Broker Procurement
On November 5, DHCS released
Invitation for Proposal (IFP) 25-007 to entities that may be able to deliver Medi-Cal managed care plan enrollment services. The enrollment broker helps Medi-Cal members enroll in, change, or leave Medi-Cal managed care plans; assists Medi-Cal members with selecting a primary care provider; creates and distributes informational materials; and supports member education and outreach. DHCS will award a single contract to the applicant that meets all qualifications and demonstrates the greatest overall value to the state. The opportunity is open to all eligible applicants, including commercial businesses, nonprofit organizations, state or public universities (including auxiliary organizations), and other entities that meet the proposal requirements. For more information about this procurement, please visit the
Procurement and Contract Division webpage.
Medi-Cal Rx Physician Administered Drug Policy Updates
As announced in the 30-Day Countdown: Upcoming Policy Change to Medi-Cal Rx Physician Administered Drugs
alert issued on October 17, DHCS implemented changes to the Medi-Cal Rx Physician Administered Drug (PAD) Policy, which had some unintended downstream impacts for both providers and members relative to accessing certain PADs. To mitigate these impacts and ensure continued access, DHCS temporarily rolled back the recent policy updates and quickly reinstated the prior policy. To promote greater awareness, on October 30, DHCS published an
alert on the Medi-Cal Rx website.
DHCS will soon schedule meetings with key stakeholders, including pharmacy providers, prescribers, and managed care plans, for increased transparency and to assist DHCS with finalizing PAD policy changes prior to implementation. This is to ensure the policy meets DHCS' overarching intent and facilitates continued access to care. Once the PAD policy is finalized through this process and an implementation date is determined, DHCS will provide advance notice to pharmacy providers, prescribers, and managed care plans through normal channels to ensure overall readiness.
Join Our Team
DHCS is hiring for its Accounting, Licensing and Certification Division, Quality and Population Health Management program, and other teams. For more information, please visit the
CalCareers website.
Upcoming Stakeholder Meetings and Webinars
DHCS posts upcoming public meetings on the DHCS
Calendar of Events. DHCS provides free assistive services, including language interpretation, real-time captioning, and alternate formatting of meeting materials. To request services, please email DHCS at the appropriate contact email address at least ten working days before the meeting.
Proposition 64 Advisory Group Meeting
On November 13, from 10 a.m. to 2 p.m. PST, DHCS will host the
Proposition 64 Advisory Group meeting. The meeting will be held in hybrid format at the Sierra Health Foundation Center for Health Program Management, 2150 River Plaza Drive, Suite 400, Sacramento. At the meeting, participants will hear presentations from DHCS, the California Natural Resources Agency, the California Departments of Social Services and Public Health, and The Center at Sierra Health Foundation on progress achieved over the last year with their Proposition 64 Youth Education, Prevention, Early Intervention and Treatment (YEPEITA)-funded programs. Meeting information, including the agenda and other materials, will be posted on the
Proposition 64 Advisory Group webpage. Please email your questions to
DHCSProp64@dhcs.ca.gov.
CalAIM MLTSS and Duals Integration Workgroup Meeting
On November 19, from 12 to 1:30 p.m. PST, DHCS will host the California Advancing and Innovating Medi-Cal (CalAIM)
Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup meeting (advance registration required). The workgroup is a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members. It allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare. The meeting agenda includes updates on the 2026 Medi-Medi Plan expansion, Exclusively Aligned Enrollment (EAE) Dual Eligible Special Needs Plan (D-SNP) default enrollment pilot, and 2026 D-SNP State Medicaid Agency Contract and Policy Guide. It will also cover Medi-Medi Plan coordination with county behavioral health and duals data on Medicare Enrollment. More information, background materials, transcripts, and video recordings of previous workgroup meetings are posted on the
CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at
info@calduals.org.
Coverage Ambassador Webinar Series
On November 20, from 11 a.m. to 12 p.m. PST, DHCS will host a
Coverage Ambassador webinar (advanced registration required). DHCS will share overviews of the Medi-Cal adult expansion enrollment freeze and asset limit reinstatement and upcoming changes to the Medi-Cal Rx pharmacy benefit. Coverage Ambassadors help spread the word about Medi-Cal benefits, enrollment information, and new projects focused on creating a healthy California for all. Please visit the
Coverage Ambassador website for more information, including how to
subscribe to receive regular updates.
In Case You Missed It
Proposed Amendment to Medi-Cal Home and Community-Based Services (HCBS) 1915(c) Waiver for Californians with Developmental Disabilities
DHCS is seeking input from members, providers, and other interested stakeholders on the proposed amendment to the Medi-Cal HCBS 1915(c) Waiver for Californians with Developmental Disabilities (HCBS-DD waiver). DHCS plans to submit the proposed waiver amendment to the federal Centers for Medicare & Medicaid Services (CMS) by November 28, for a proposed effective date of March 1, 2026. Copies of the proposed amendment can be obtained and comments may be submitted by emailing Federal.Programs@dds.ca.gov. Please include “HCBS Waiver" in the subject line or message. To ensure consideration, comments must be received by November 12. While comments submitted after this date will still be accepted, DHCS may not be able to review them before submitting the HCBS-DD waiver amendment to CMS.
