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​​​Dear Partners and Stakeholders, 

Thank you for helping us achieve another banner year at DHCS. We're implementing a multi-year transformation of Medi-Cal to ensure Californians can get the care they need. Together, we are setting a new standard for equitable, person-centered care. Our new five-year Strategic Plan captures the bold actions we are taking to ensure California's health care delivery system results in all Californians living healthier, happier lives.

Every day, Californians are gaining access to new and improved services—or getting covered for the first time. We're addressing some of the most pressing issues of our time, including homelessness and youth mental health needs. We're building and expanding our programs to treat the whole person—both physical and behavioral health—and addressing health-related social needs by offering Enhanced Care Management (ECM) and Community Supports, such as transitions to stable housing and/or providing access to medically tailored meals. Together, these changes represent a significant step forward in delivering a more coordinated, person-centered, and equitable health care system that works for everyone, wherever you live or whatever your health needs. Although these changes will take time to fully implement, we should feel tremendously proud of what we're doing to transform people's lives. Your work brings us closer to realizing our purpose of a healthy California for all.

As 2023 ends, DHCS reflects on some of the Department's many accomplishments this year:
​​

We are helping to ensure access to comprehensive care.

  • Prepared to expand health coverage to hundreds of thousands of California adults ages 26 through 49, regardless of their immigration status, on January 1, 2024.
  • Conducted a robust readiness review of all Medi-Cal managed care plans (MCP) to assess whether they could “go-live" with the new MCP contract effective on January 1, 2024. This is a culmination of a multi-year effort to implement county plan model changes and directly contract with a new mix of commercial MCPs statewide. All MCPs were deemed ready to go live, with about 1.2 million Medi-Cal members anticipated to change MCPs on January 1, 2024. The new 2024 MCP contracts between DHCS and MCPs will cover the vast majority of Medi-Cal members and require plans to advance health equity, quality, access, accountability, and transparency.
  • Began the Medi-Cal continuous coverage unwinding period to help millions of Medi-Cal members keep their coverage, and eased the administrative burden on both Medi-Cal members and local county offices during this unwinding by partnering with counties to submit and receive approval of 17 flexibility waivers from the federal government.
  • Issued more than $1 billion in Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments and Clinic Workforce Stabilization Retention Payments to more than 900,000 health care workers. 
  • Awarded $150 million in grants to 262 organizations to support the mental health and wellness of children, youth, and young adults, as part of the Children and Youth Behavioral Health Initiative (CYBHI).
  • Awarded more than $64.5 million in funding to correctional agencies, or their designees, to support planning with county social services departments and other enrollment partners to implement Medi-Cal application enrollment for people during incarceration.
  • Used a phased, iterative approach to complete reinstatement of Medi-Cal Rx utilization management controls for adult (members 22 year of age and older) pharmacy benefits, including medications, enteral nutrition products, and medical supplies. DHCS worked closely with MCPs and health care associations to ensure that members maintained access to services and to minimize administrative barriers among prescribers and pharmacy providers.
 

We are offering new and expanded services to support both Medi-Cal and non-Medi-Cal eligible individuals, with an emphasis on children and their parents.

  • Implemented dyadic services as a new benefit to support healthy child development and mental health among children and their parents.
  • Implemented doula services as a new benefit to help prevent perinatal complications, reduce disparities, and improve maternal and infant health outcomes. 
  • Expanded eligibility for the Hearing Aid Coverage for Children Program.
  • Significantly expanded the Continuous Glucose Monitor (CGM) benefit and improved access to diabetic supplies with updates to coverage policy, quantity, and frequency utilization controls in 2023. California was recognized for being one of the leaders in the country on making CGMs available to more members.
  • Launched DHCS' Birthing Care Pathway initiative to transform maternity care in Medi-Cal.
  • Completed two years of participation in the federal Centers for Medicare & Medicaid Services' Infant Well Child Visit Learning Collaborative, and was selected to present on our suggestions nationally.
  • Launched the Children and Youth ECM Population of Focus statewide.​
 

We are improving the quality and health equity of care delivered in Medi-Cal to achieve whole-person health and wellness.

  • Improved accountability for quality for our Medi-Cal MCPs for the second year in a row to ensure plans meet our minimum performance levels, and reported on behavioral health clinical quality measures for the first year.
  • Successfully implemented regional technical assistance on quality and health equity for Medi-Cal managed care and county behavioral health plans.
  • Completed the soft launch of our Health Equity Roadmap to listen to member needs and priorities for health equity in Medi-Cal.
 

We are addressing behavioral health and housing needs.

  • Continued the Behavioral Health Bridge Housing Program, a $1.5 billion investment to address housing instability and give Californians the housing and community-based housing support they need. The funding will support county behavioral health agencies and tribal entities with operational costs for shelter and interim housing, rental assistance, and auxiliary funding in assisted living settings for people experiencing homelessness with serious behavioral health conditions.
  • Continued to advance the goals of the Housing and Homelessness Incentive Program, allowing MCPs to earn incentive funds for making investments in addressing homelessness. Incentives totaling $1.3 billion were available for achievement of performance milestones and metrics.
  • Awarded $430 million as part of the Behavioral Health Continuum Infrastructure Program in 2023, for a total investment of close to $1.6 billion to date. In full, DHCS is releasing $2.1 billion through six grant rounds targeting various gaps in the state's behavioral health facility infrastructure.
  • Empowered Medi-Cal MCPs to offer 14 Community Supports to eligible Medi-Cal members, including three housing-related services (i.e., housing deposits, housing tenancy and sustaining services, and housing transition navigation services).
  • Launched Providing Access and Transforming Health (PATH), a five-year, $1.85 billion initiative to build up the capacity and infrastructure of on-the-ground partners, such as community-based organizations (CBO), public hospitals, county agencies, tribes, and others, to successfully participate in the Medi-Cal delivery system as California widely implements ECM and Community Supports and justice-involved services under CalAIM.
  • DHCS invested $351 million in 282 entities interested in becoming ECM and Community Supports providers a as part of the PATH Capacity and Infrastructure, Transition, Expansion, and Development (CITED) initiative.
  • Launched the PATH Technical Assistant (TA) Marketplace, which serves as a virtual marketplace for TA services, a one-stop-shop website where entities can access TA resources from curated and approved vendors. The TA Marketplace initiative provides funding for providers, CBOs, counties, and others to obtain TA resources to establish the infrastructure needed to implement ECM and Community Supports.
  • Submitted a Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Section 1115 demonstration waiver to the federal government that would expand access to and strengthen the continuum of community-based behavioral health services for Medi-Cal members living with serious mental illness and serious emotional disturbance.
  • Submitted 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 voluntary for Medi-Cal MCPs to offer and for Medi-Cal members to use. ​
 

We are modernizing behavioral health care to help members more seamlessly access mental health and substance use disorder (SUD) treatment services​.​

  • Implemented new Screening and Transition Tools for Medi-Cal Mental Health Services to determine the most appropriate Medi-Cal mental health delivery system referral for members who are not currently receiving mental health services.
  • Implemented Behavioral Health Payment Reform, moving counties away from cost-based reimbursement to value-based reimbursement structures that reward better care and quality of life for Medi-Cal members.
  • Implemented the first phase of the Community Assistance, Recovery, and Empowerment (CARE) Act, a new civil court process that provides community-based behavioral health services and supports to Californians living with untreated schizophrenia spectrum or other psychotic disorders. The CARE Act is being implemented in two phases. The counties of Glenn, Orange, Riverside, San Diego, Stanislaus, and Tuolumne, and the City and County of San Francisco (Cohort I) implemented the CARE Act on October 1, 2023. Los Angeles County implemented on December 1, 2023, and all other counties (Cohort II) are required to implement the CARE Act by December 1, 2024.
  • Instituted a new requirement that licensed and certified SUD recovery or treatment facilities must offer Medication Assisted Treatment (MAT) services directly to clients or have an effective referral process in place to ensure all members receiving treatment for SUD have onsite access to evidence-based care.
 

We are supporting providers and expanding provider types in all delivery systems.

  • Secured legislative and federal approval of a new Managed Care Organization (MCO) Tax, effective April 1, 2023, through December 31, 2026. The tax is expected to generate a net benefit of $19.4 billion for the State of California. Tax revenues will be reinvested in the Medi-Cal program as the nonfederal share of expenditures for existing health care services and for targeted provider rate increases and other investments.
  • Established CBO as a new provider type to provide Community Health Worker, asthma preventive, and justice-involved services in 2024. Effective January 8, 2024, CBO and local health jurisdiction providers requesting enrollment in the Medi-Cal program can submit applications through the Provider Application for Validation and Enrollment (PAVE) online enrollment portal.
  • Provided grants to 27 Indian Health Programs to support primary care recruitment and retention efforts.
  • Updated the Medi-Cal provider website with a new provider portal that enhances the provider's experience with the Medi-Cal program.
  • Submitted a federal waiver proposal, that once approved, will invest $2.4 billion in a five-year behavioral health workforce development program. This initiative complements the Workforce for a Healthy California Initiative, the state's broader strategy to build a health workforce that represents California's diverse communities and provides people with the quality care they deserve while addressing the growing workforce shortages throughout the state's health and human services system.
 

We are modernizing systems to improve efficiency and productivity.

  • Successfully migrated all 58 counties to a single Medi-Cal eligibility and enrollment system, California Statewide Automated Welfare System (CalSAWS), so Medi-Cal members can easily connect to other social services programs, such as CalWORKs and CalFresh, using the same portal.
  • Selected vendors and have been working diligently with our partners to get ready for the January 2024 launch of two youth behavioral health virtual services platforms – Soluna and BrightLife Kids.  
  • Rolled out several new dashboards to improve transparency and accountability, including dashboards for the Continuous Coverage Unwinding, Long-Term Services and Supports, Dual Eligible Special Needs Plan (D-SNP), and ECM and Community Supports.
 

We are strengthening our connection with Medi-Cal members, partners, stakeholders, and others we serve.

  • Released a new five-year Strategic Plan that captures the bold actions we are taking to ensure California's health care delivery system results in all Californians living healthier, happier lives. DHCS takes seriously its organizational purpose to provide equitable access to quality health care leading to a healthy California for all.
  • Established the Medi-Cal Member Advisory Committee to provide Medi-Cal members a forum to provide direct feedback to DHCS leadership. To date, three quarterly meetings have been held.
  • Built a Coverage Ambassador program to help Health Enrollment Navigators, advocates, CBOs, schools, health providers, and community members, such as promotoras and other likeminded individuals, help Californians navigate their Medi-Cal renewals and coverage opportunities. We held numerous trainings and webinars to share best practices and have provided 117 unique outreach pieces in all 19 Medi-Cal threshold languages.
  • Released an Early and Periodic Screening, Diagnostic, and Treatment Education & Outreach Toolkit (EPSDT Toolkit), featuring two enrollee-facing brochures, a letter explaining Medi-Cal rights for kids and teens, and a standardized provider informational training on EPSDT benefits, to help promote understanding of and access to EPSDT-covered services (now known as “Medi-Cal for Kids and Teens"), which are available to all children and youth enrolled in Medi-Cal. ​
 

We are strengthening our internal operations to better serve Californians​.​​

  • Submitted all annual financial statements on time for the second year in a row.
  • Implemented an enterprise candidate pool list for analysts process to centralize and expedite hiring efforts.
  • Deployed Microsoft Teams Phones (softphones) so all employees have a single phone number that will reach them in a hybrid telework environment, either at an alternate work location or the office.
 
Our work to transform health care in California continues, and the new year promises to be another exciting year for DHCS as we work toward building a healthier, more equitable state. Thank you for your partnership, advocacy, and interest, and for your continued contributions toward a healthy California for all. 
 
Yours in service,

Michelle Baass

DIRECTOR​

Last modified date: 1/18/2024 12:53 PM