DHCS Stakeholder News - August 19, 2022
Dear Stakeholders,
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs.
Top News
Governor Unveils California's Strategy to Support Youth Mental Health; Children and Youth Behavioral Health Initiative (CYBHI) is a Key Component
On August 18 in Fresno, Governor Gavin Newsom discussed California's Master Plan for Kids' Mental Health. He said, “Mental and behavioral health is one of the greatest challenges of our time…The Master Plan for Kids' Mental Health is premised on a very simple belief: every single kid deserves to have their mental health supported."
One of the key components of the Master Plan is CYBHI, a multiyear, multi-department package of investments that reimagines the systems that support behavioral health for all California's children, youth, and their families. Efforts focus on promoting social and emotional well-being, preventing behavioral health challenges, and providing equitable, appropriate, timely, and accessible services for emerging and existing behavioral health needs for children and youth ages 0-25.
The $4.7 billion investment of state General Funds for CYBHI will improve access to behavioral health services for all children and youth in California, regardless of payer. Moreover, it will have significant implications for the Medi-Cal program since 5.4 million (approximately 54 percent) children and youth are enrolled in Medi-Cal. CYBHI will improve and change the way Medi-Cal's children and youth access behavioral health service—virtually, through their communities and schools, and through their existing relationships with Medi-Cal managed care plans (MCP) and County Behavioral Health Plans.
As a component of CYBHI, DHCS will build and drive adoption of the Behavioral Health Virtual Services Platform for all children, youth, and families in California, regardless of payer. The platform will support the delivery of equitable, appropriate, and timely behavioral health services from prevention to treatment to recovery, and provide an e-Consult platform for pediatric and primary care providers to connect with BH providers.
CYBHI also includes statewide efforts that will make it easier for children, youth, and young adults to access behavioral health services in California's schools. By January 1, 2024, DHCS, in collaboration with the California Department of Managed Health Care (DHMC), will develop and maintain:
- A school-linked statewide fee schedule to reimburse outpatient mental health and substance use disorder services provided to a student, 25 years of age or younger, at or near a school-site;
- A school-linked statewide provider network of school-site behavioral health counselors.
The statewide all-payer fee schedule for school-linked BH services will provide a specific scope of benefits and rate requirements for commercial health plans and the Medi-Cal delivery systems, which will be required to reimburse providers at the established rates for providing services to students. Establishing the fee schedule will streamline and facilitate reimbursement for school-based behavioral health services, thereby expanding the scope of behavioral health services provided to students at, or near, school sites, and improving access to services and outcomes for children, youth, and young adults.
DHCS is leading the following additional efforts to expand access to school-linked behavioral health services:
- The Student Behavioral Health Incentive Program (SBHIP) provides incentive payments, totaling $389 million over a three-year period (January 1, 2022 – December 31, 2024), to Medi-Cal MCPs to build sustainable partnerships and infrastructure between MCPs, Local Educational Agencies (LEAs), and counties to:
- Improve coordination of student behavioral health (BH) services;
- Increase preventive and early intervention BH services for transitional kindergarten to12 grade students;
- Increase non-specialty mental health services on/near school campuses;
- Increase access to BH services on/near school campuses and/or through school-affiliated BH providers.
- DHCS will provide direct School-linked Partnership and Capacity Grants to support new services to individuals 25 years of age and younger from schools, providers in school, school-affiliated community-based organizations (CBOs), or school-based health centers. By improving capacity, partnerships, and infrastructure, DHCS will continue to expand access to school-based services for students. The grants will be designed to support the implementation of the statewide all-payer fee schedule in 2024.
- Through its CalHOPE initiative, DHCS is investing in social and emotional learning (SEL) environments for children and youth in school settings. The Department is contracting with the Sacramento County Office of Education (COE), which has memorandums of understanding with all 57 other COEs across the state, to lead implementation efforts, including establishing a statewide SEL Community of Practice. Each COE is developing a needs assessment and action plan to expand SEL strategies.
Effective January 2023, Medi-Cal will cover integrated physical and behavioral health screenings and services for the whole family, not just the child who is the identified patient. This expansion is especially important for families in which the child is enrolled in Medi-Cal but the parent or caregiver is uninsured, and yet there is a need for dyadic treatment. Dyadic services involve simultaneous treatment for the child and parent/caregiver, with studies showing significant improvements in child behavior issues and increases in positive parent/child attachment. These services will include a number of screening, assessment, evaluation, and case management, in addition to integrated BH services, tobacco cessation counseling, and alcohol and/or drug use Screening, Brief Interventions and Referral to Treatment.
In addition, with input from stakeholders, DHCS will select a limited number of evidence-based practices (EBPs) and community-defined practices (CDPs) to scale throughout the state based on robust evidence for effectiveness, impact on racial equity, and sustainability. Medi-Cal MCPs, county BH plans, Medi-Cal providers and Indian Health programs would then be eligible to receive funding for scaling up these practices. By scaling EBPs and CDPs throughout the state, DHCS aims to improve access to critical BH interventions, including those focused on prevention, early intervention and resiliency/recovery, for children and youth, specifically focused on children and youth from Black, Indigenous, and people of color and lesbian, gay, bisexual, transgender, queer and intersex+ communities.
To provide comments, make recommendations, or obtain additional information about the CYBHI, please email
CYBHI@dhcs.ca.gov.
Contingency Management (CM) Request for Proposal (RFP)
On August 19, 2022, DHCS
issued a RFP to support implementation of the California Advancing and Innovating Medi-Cal (CalAIM) CM pilot program. Through the pilot, DHCS is committed to expanding access to evidence-based behavioral treatment to address the stimulant use disorder crisis that persists in California. CM, which provides motivational incentives to reduce the use of stimulants, is the only treatment that has demonstrated strongly positive outcomes for individuals with stimulant use disorder, including a reduction in or cessation of drug use and longer retention in treatment.
DHCS will implement the CM pilot program using an incentive manager vendor. The RFP seeks a vendor that would support the, management, tracking, and distribution of incentives. The pilot was scheduled to begin on July 1, 2022, but the inability to procure an incentive manager delayed implementation. Therefore, the new incentive manager vendor will likely onboard in November, and the anticipated CM pilot program start date will be in December or January 2023.
For more information, please visit the DHCS CM program webpage.
Program Updates
Providing Access and Transforming Health Funding for Justice-Involved (PATH JI) Capacity Building Program
On August 9, DHCS launched an
online application for round two of the PATH JI Capacity Building Program to support activities focused on pre-release Medi-Cal eligibility and enrollment for justice involved Californians.
PATH JI Capacity Building Program funding supports collaborative planning as well as information technology (IT) system modifications necessary to implement pre-release Medi-Cal application and suspension processes. This program is providing a total of $151 million for correctional agencies and institutions and county social service departments, including sheriff's offices, county probation departments, and the California Department of Corrections and Rehabilitation. Applications for round two must be submitted through the online application portal no later than December 31, 2022.
Visit the
CalAIM PATH webpage for more information on PATH and the JI initiative. Please email
justice-involved@ca-path.com with any questions about the application process.
Provider Application and Validation for Enrollment (PAVE) Portal for Family PACT Providers
On August 15, DHCS launched the
PAVE portal for Family PACT (Planning, Access, Care, and Treatment) providers. The PAVE portal is a web-based application designed to simplify and accelerate enrollment processes, it is a new mode for submitting Family PACT provider enrollment applications and required documentation to DHCS. Beginning January 1, 2023, DHCS will no longer accept paper applications from providers seeking to enroll as a Family PACT provider.
CMS Approval of Three State Plan Amendments (SPA) for Benefits
- On August 5, CMS approved SPA 22-0044 to allow “licensed practitioners" to prescribe physical therapy. This revision allows physician assistants and nurse practitioners to prescribe physician therapy, in addition to physicians, dentists, and podiatrists.
- On August 10, CMS approved SPA 22-0003 to add asthma preventive services. This new benefit authorizes unlicensed asthma preventive service providers and licensed practitioners to provide asthma education and home assessments.
- On August 12, CMS approved SPA 22-0017 to authorize routine patient costs for clinical trials, as required by the Consolidated Appropriations Act of 2021. Previously, Medi-Cal covered routine costs for clinical trials only for participants in clinical trials for cancer.
Published COVID-19 Information
Upcoming Stakeholder Meetings and Webinars
CalAIM Waiver Amendment Public Hearing
On August 22, DHCS is hosting a virtual public hearing to encourage and solicit stakeholder feedback on
proposed waiver amendments regarding implementation of county-based model changes in the Medi-Cal Managed Care (MCMC) program. Advance registration for the CalAIM public hearing is required.
Additional information about the CalAIM Section 1115 demonstration application and the Section 1915(b) overview is available on the CalAIM 1115 Demonstration & 1915(b) Waiver webpage. The 30-day public comment period ends on September 12, 2022.
PATH Capacity and Infrastructure Transition, Expansion and Development (CITED) Initiative Update
On August 23 at 12 p.m., DHCS will virtually host an informational webinar to support eligible entities with their CITED application. DHCS will host another informational webinar on September 8 at 2:30 p.m. The webinars will provide detailed information on CITED funds and the application process.
For more information, please visit https://www.ca-path.com/cited. Questions about the CITED initiative and the application process can be submitted to cited@ca-path.com. DHCS will respond to submitted questions during the webinars and in follow-up communications.
CalAIM Webinar: ECM and Community Supports Member Engagement
On August 25 at 1:30 p.m., DHCS will virtually host a webinar on CalAIM ECM and Community Supports member engagement. Topics for this session will include provider and member communications, referrals, outreach, and enrollment.
CalAIM Member Engagement webinar advance registration is required. Participants are invited to submit questions by August 22 to
CalAIMECMILOS@dhcs.ca.gov. Attendees will also have the opportunity to ask questions during the session. An additional “Office Hours" event will be held on September 1 at 2 p.m. for attendees to ask questions not covered during the webinar.
CYBHI Monthly Public Webinar
On August 29 at 3 p.m., DHCS will virtually host a public webinar to keep stakeholders apprised of DHCS' progress in implementing various work streams for the CYBHI. Key attendees include, but are not limited to, youth, parents, family members, behavioral health providers, Medi-Cal managed care plans, county behavioral health departments, and commercial health plans, as well as education and other cross-sector partners.
Advance registration for this CYBHI webinar is required.
CalAIM “Office Hours": ECM and Community Supports Member Engagement
On September 1 at 2 p.m., DHCS will virtually host an “Office Hours" discussion on CalAIM ECM and Community Supports member engagement. As a follow-up to the August 25 webinar on this topic, this Q&A session will cover provider and member communications, referrals, outreach, and enrollment. Advance registration is required. Participants are invited to submit questions by August 29 to
CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.
CalAIM Webinar: ECM Long-Term Care Populations of Focus
On September 8 at 1:30 p.m., DHCS will virtually host an all-comers webinar on CalAIM ECM Long-Term Care Populations of Focus. Advance registration is required. Participants are invited to submit questions by September 5 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.
