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CMS Approves California's BH-CONNECT Initiative to Transform Behavioral Health Services
The Centers for Medicare & Medicaid Services (CMS)
approved the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration. This
transformative initiative will expand access to essential behavioral health services for Medi-Cal members with significant mental health and substance use needs. Key features of BH-CONNECT include:
- Workforce Investments: Supports a $1.9 billion robust and diverse behavioral health workforce initiative that includes scholarships, loan repayment programs, recruitment incentives, residency and fellowship expansions, and professional development. The workforce initiative will be managed by the Department of Health Care Access and Information (HCAI).
- Transitional Rent Assistance: Provides up to six months of rental support, through a member's managed care plan, for eligible Medi-Cal members transitioning from institutions, congregate settings, or homelessness. This support is crucial in stabilizing individuals during vulnerable periods, significantly reducing the risk of returning to institutional care or experiencing homelessness. Transitional rent will serve as a bridge to permanent housing for members who need it. For members with significant behavioral health needs, the Behavioral Health Transformation funding dedicated to Housing Interventions will provide permanent rental subsidies and housing following Transitional Rent, providing seamless continuity, and supporting members in achieving long-term housing stability.
- Support for Children and Youth: Includes activity funds to improve access and outcomes for youth involved in child welfare receiving specialty mental health services.
- Incentives for Counties: Supports a $1.9 billion Access, Reform, and Outcomes Incentive Program: Rewards county behavioral health plans for improving access, reducing disparities, and strengthening behavioral health quality improvement.
- Community Transition In-Reach Services: Supports members transitioning from long-term institutional stays to ensure continuity of care and successful reintegration into the community.
- Short-term Inpatient Psychiatric Care: Provides new flexibility for federal Medi-Cal funding for short-term mental health care provided in inpatient and residential treatment settings that meet the federal institution for mental diseases criteria.
In parallel with the expenditure and waiver authorities granted as part of the Section 1115 demonstration approval, DHCS is implementing other features of the BH-CONNECT demonstration that do not require Section 1115 demonstration authority, including:
- Medi-Cal coverage for evidence-based practices (EBP), including (available at county option):
- Assertive Community Treatment (ACT), a comprehensive, community-based, interdisciplinary team-based service model to help individuals with serious mental illness cope with the symptoms of their mental health condition and develop or restore skills to function in the community.
- Forensic ACT, an ACT program tailored for individuals who are involved with the justice system.
- Coordinated Specialty Care for First Episode Psychosis, a comprehensive, community-based, interdisciplinary team-based service model to help individuals cope with the symptoms of early psychosis and remain integrated in the community.
- Individual Placement and Support Model of Supported Employment, community and team-based services that helps individuals with behavioral health conditions to lead functional and productive lives in the community, including acquiring and/or maintaining competitive employment.
- Community Health Worker Services, preventive services delivered through the specialty behavioral health delivery systems by trusted community members provide health education, advocacy, and navigation services to support members with accessing need health care and community resources to address social drivers of health.
- Clubhouse Services, services offered within rehabilitative programs that provide a physical location for people living with significant behavioral health needs to build relationships, engage in work and education activities, and receive supportive services.
- Clarification of Medi-Cal coverage requirements for evidence-based practices (EBPs) for children and youth, including Multisystemic Therapy, Functional Family Therapy, Parent-Child Interaction Therapy, and High-Fidelity Wraparound (implemented statewide). By providing clearer guidelines and coverage requirements for these EBPs, BH-CONNECT aims to ensure that more children and youth in California have access to these effective treatments.
- A management-level County Child Welfare Liaison within managed care plans to oversee and deliver Enhanced Care Management, attend Child and Family Team meetings, ensure managed care services are coordinated with other services, and serve as a point of escalation for care managers if they face operational obstacles (implemented statewide).
- Centers of Excellence providing training and technical assistance to behavioral health delivery systems and providers to support the integrity of treatment and delivery of EBPs (implemented statewide).
- Child welfare/specialty mental health joint visit when a child enters welfare (implemented statewide).
This multi-billion-dollar initiative combines federal, state, and local investments to create a more robust, equitable behavioral health system that prioritizes community-based solutions. By reducing emergency department visits and institutional stays, BH-CONNECT will help Californians achieve stability and recovery while building a stronger workforce and infrastructure to support long-term improvements.
Stay tuned for further updates, including stakeholder engagement opportunities and additional program details. Visit the DHCS
BH-CONNECT webpage for more information.
Additionally, CMS approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) section 1115 demonstration, effective through December 31, 2026. The CalAIM amendment expands the service duration and frequency criteria for several Community Supports, including Recuperative Care (Medical Respite) and Short-Term Post-Hospitalization Housing services, in alignment with CMS' national policy, and makes other technical changes.
Join Our Team
DHCS is seeking a talented and motivated individual to serve as:
- Chief of the Managed Care Quality and Monitoring Division to lead compliance-related activities for the state's Medi-Cal managed care plans. These activities include, but are not limited to, developing and implementing policies, establishing standard operating procedures, engaging in continual improvement efforts, providing technical assistance, and conducting risk analysis for managed care plan audit programs in partnership with DHCS' Contract and Enrollment Review Division. Applications must be submitted by December 26.
DHCS is also hiring for its health policy, information technology, and other teams. For more information, please visit the
CalCareers website.
Upcoming Stakeholder Meetings and Webinars
Long-Term Care (LTC) Learning Series: Managed Care Resources for LTC Providers
On December 17, from 9 to 10:30 a.m. PST, DHCS will host the Managed Care Resources for LTC Providers session (
advanced registration required) as part of its educational LTC Learning Series. This session is designed for providers working in skilled nursing facilities, subacute care facilities, and intermediate care facilities for the developmentally disabled. Topics include Medi-Cal eligibility and managed care plan enrollment, LTC authorizations, and managed care billing and payment. Additionally, the agenda includes an overview of newly developed resources that provide information and helpful tips on various managed care topics. The session will feature managed care plan guest speakers.
LTC Learning Series participants are encouraged to submit questions in advance when registering for the session or by emailing them to
LTCtransition@dhcs.ca.gov. Additional details about the LTC Learning Series are available on the
CalAIM LTC Carve-In transition webpage.
DHCS Harm Reduction Summits
DHCS aims to collaborate with communities across the state to promote harm reduction and low-barrier, patient-centered care within California's substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno, Los Angeles, and San Diego counties in winter 2025. Register on the
event website.
In Case You Missed It
Transition to Medicare Part A Buy-In Agreement
On January 1, 2025, California will become a
Medicare Part A buy-in state, meaning eligible Medi-Cal members will receive Medicare Part A services for free if they are enrolled in Medicare Part B and they qualify for the Qualified Medicare Beneficiary (QMB) program. For these members, Medicare, instead of Medi-Cal, will provide primary coverage for hospitalizations and other inpatient benefits covered through Medicare Part A. California's new Medicare Part A buy-in agreement with the federal Centers for Medicare & Medicaid Services will eliminate the conditional enrollment requirements for Medicare Part A at the Social Security Administration. As a Part A buy-in state, California can enroll eligible QMB members in Medicare Part A year-round through a streamlined enrollment process without any late enrollment penalties.
Providing Access and Transforming Health (PATH) Capacity and Infrastructure, Transition, Expansion, and Development (CITED) Round 4 Application
On January 6, 2025, DHCS will open the PATH CITED Round 4 application window. 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. The deadline to apply for CITED Round 4 funding is 11:59 p.m. PST on March 7, 2025. Interested organizations are encouraged to access the application outline and guidance document to help prepare their application. Please submit questions to cited@ca-path.com.
