Top News
Additional Medi-Cal Eligibility Federal Flexibilities Approved
On June 29, 2023, the Centers for Medicare & Medicaid Services (CMS) approved DHCS' two requests for federal waiver authority to help streamline the processing of annual Medi-Cal eligibility renewals and ease burdens on county program administrators and Medi-Cal members. The first flexibility waives the verification requirement for individuals whose income is under 100 percent of the federal poverty level (FPL) and who meet certain criteria. The second allows counties greater flexibility to redetermine eligibility and extend the renewal date when contact is made with hard-to-reach populations, such as unhoused individuals, seniors, and persons with disabilities. Both flexibilities will streamline renewal processing for Medi-Cal members, especially vulnerable populations, and ease burdens to provide additional paperwork or documentation during the continuous coverage unwinding period.
Both waivers are effective on June 1, 2023, and will continue throughout the unwinding period. DHCS issued
Medi-Cal Eligibility Division Letter (MEDIL) 23-40 to provide counties with immediate guidance on operationalizing these flexibilities.
Program Updates
DHCS Releases Report about California Medicare Beneficiaries Near Income Eligibility for Medi-Cal
On July 3,
DHCS released a Medicare data chartbook, entitled “Profile of Older Californians: Medicare Beneficiaries Near Income Eligibility for Medi-Cal". This chartbook includes information about Californians with Medicare, specifically focusing on the 13 percent of Medicare beneficiaries 65 years of age and older who are just above the Medi-Cal income limit (139 to 220 percent of the FPL). Understanding the demographics, resources, and accessibility needs of this population is important to DHCS as it considers programs and policies to meet the health and social needs of California's diverse communities.
The report found that this population has a demographic profile similar to Medi-Cal income-eligible members but they are not eligible for Medi-Cal long-term services and supports, Key findings include:
- 48 percent were age 75 or older, compared to Medicare beneficiaries with higher incomes (38 percent).
- 45 percent had Black, Latino, and Asian identities compared to Medicare 28 percent of beneficiaries with higher incomes.
- 15 percent had limited English proficiency, compared to 4 percent of beneficiaries with higher incomes.
- 59 percent were female, compared to 51 percent of beneficiaries with higher incomes.
Funded by The SCAN Foundation, the chartbook is based upon an analysis of 2015-2019 U.S. Census American Community Survey data. DHCS will discuss the highlights of the chartbook with stakeholders in a
webinar on July 17 (see below for details).
Indian Health Program (IHP) Grant Program Funding Increase
The FY 2023-24 budget allocated an additional $11 million for the IHP grant program, bringing total funds to more than $22.5 million. The funds will be used to assist California tribal partners in reducing health disparities by ensuring American Indians have access to quality health care, supporting the equitable delivery of health care in Indian health clinics by expanding care delivery capacity, focusing on care that is delivered in a culturally appropriate manner, supporting access to traditional Indian health, and strengthening Indian health safety net clinic programs. In addition, $22.6 million was allocated yearly beginning in FY 2024-25 to support ongoing funding of the IHP grant program. DHCS looks forward to working with tribal partners to use these grants to improve the health status of American Indians in California. For questions, please email
TribalAffairs@dhcs.ca.gov.
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 is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS' mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
Upcoming Stakeholder Meetings and Webinars
2024 Managed Care Plan Transition Policy Guide Webinar
On July 10, from 1 to 2 p.m., DHCS will host a
webinar (advance registration required) to introduce the
2024 Medi-Cal Managed Care Plan Transition Policy Guide, which includes DHCS policy and Medi-Cal managed care plan (MCP) requirements related to member transitions taking effect on January 1, 2024.
The guide addresses protections for American Indian/Alaska Native members, member noticing requirements and member enrollment policies applicable to transitioning and new members, and continuity of care requirements for members transitioning due to MCP contracting changes. It also addresses MCP requirements to ensure Medi-Cal members determined eligible to receive Enhanced Care Management (ECM) and Community Supports do not experience disruptions to their authorizations, provider relationships, or services.
Companion All Plan Letter 23-018 establishes the binding nature of the guide as the DHCS authority specific to the 2024 MCP transition. The guide will be updated throughout calendar year 2023 to keep MCPs informed of new and developing guidance.
CalAIM Population Health Management (PHM) Advisory Group July Meeting
On July 12, from 11:30 a.m. to 1 p.m., DHCS will host the
PHM Advisory Group meeting (advance registration required) that will include a briefing on the policy refinements DHCS has prioritized for
ECM and Community Supports in 2023 and beyond. This meeting will cover several topics, including eligibility, referrals and authorizations, provider networks, payment, market awareness, and data exchange.
DHCS established the PHM Advisory Group to provide input to support the design and implementation of the
PHM Program and Service. Advisory Group members include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, and will participate in meetings to provide real-time feedback and recommendations. The meetings are open to the public. Meeting information and materials are posted on the
CalAIM PHM Initiative webpage.
Webinar on California's Medicare Populations
On July 17, from 10 to 11:30 a.m., DHCS will host a
webinar (advance registration required), entitled "California's Medicare Populations: Linguistic and Cultural Diversity, Plus the Near-Dual Group", that will include presentations and a panel discussion on two recently published Medicare data chartbooks, highlighting the linguistic and cultural diversity of Californians with Medicare and the demographics for Medicare beneficiaries near the Medi-Cal income eligibility threshold, known as “near-duals". The data chartbooks are available on the
DHCS Office of Medicare Innovation and Integration (OMII) webpage.
Stakeholder Advisory Committee (SAC) and Behavioral Health Stakeholder Advisory Committee (BH-SAC) Meeting
On July 20, from 9:30 a.m. to 3:15 p.m., DHCS will host the
third SAC and BH-SAC hybrid meeting of 2023 (advance registration required). It will open as a joint meeting, with topics shared by SAC and BH-SAC. There will be a BH-SAC-only meeting held after the joint meeting; there is no SAC-only meeting. Attendees can attend in person at The California Endowment, located at 1414 K Street in downtown Sacramento, or virtually. For more information, please visit the
SAC and
BH-SAC webpages.
Hearing Aid Coverage for Children Program (HACCP) Webinar for Medical Providers and Hearing Professionals
On September 14, from 12 to 1 p.m., DHCS will host a
HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff.
In Case You Missed It
Now Accepting Applications for Data Exchange Framework (DxF) Grants
The second round of the California Health & Human Services Agency's Center for Data Insights and Innovation's DxF Signatory Grants is open and accepting applications through September 1, 2023. The $47 million Data Sharing Agreement (DSA) Signatory Grants Program will provide health and social services entities that have signed the DSA with resources to address critical operational, technical, and technological barriers to DxF implementation. Entities that signed the DSA and can demonstrate that additional support and capabilities are needed to meet their DSA requirements are eligible to apply. Applicants may apply for a Technical Assistance grant, also referred to as a Qualified Health Information Organization onboarding grant. Information on these two grant domains, eligibility criteria, uses of funding, and more can be found in the
DSA Signatory Grants Guidance Document. For more information and a link to the grant application portal, please visit the Center for Data Insights and Innovation's Data Exchange Framework webpage. For questions, please email
cdii@chhs.ca.gov.
California Awards $30.5 Million for Kids' Mental Health and Support for Parents and Family Caregivers
As part of Governor Gavin Newsom's $4.7 billion Master Plan for Kids' Mental Health, DHCS
awarded $30.5 million to 63 groups to support youth mental health through community and evidence-based practices, supporting parents, grandparents, and other family caregivers. Funded through the Children and Youth Behavioral Health Initiative, the evidence-based practice (EBP) and community-defined evidence practice (CDEP) models funded include: Positive Parenting Practices, Incredible Years, Healthy Steps (Medi-Cal Dyadic Services Benefit), Parent Child Interaction Therapy, Effective Black Parenting Program, Positive Indian Parenting, and a variety of other community-defined parenting support programs. Read the Governor's Office
news release for more information.
California Awards $5.7 Million for Opioid Use Education and Outreach in 2S/LGBTQ+ Communities
As part of Governor Newsom's $1 billion Master Plan for Tackling the Fentanyl and Opioid Crisis, DHCS
awarded $5.7 million to 25 entities for opioid and stimulant use education and outreach in Two-Spirit/LGBTQ+ communities to increase awareness about opioids and stimulants, decrease stigma related to drug use and treatment, and integrate and strengthen treatment referral pathways for opioid use disorder and stimulant use disorder. Read the Governor's Office
news release for more information.
California Takes First Step in Creating Its Own Naloxone Supply
California is taking the first step toward creating a more affordable and accessible supply of Naloxone nasal products through the broader CalRx Initiative, a vital tool in combating the opioid epidemic. Under the CalRx Naloxone Access Initiative, unveiled by Governor Newsom earlier this year, the state will allocate $30 million to support a partner, or partners, in developing, manufacturing, procuring, and/or distributing a naloxone nasal product under the CalRx label. On July 6, the California Department of Health Care Access and Information issued a
Request for Information for its naloxone initiative as the state continues to take critical action to fight the ongoing opioid crisis. Read the
Governor's Office news release for more information.
