Tsib Hlis 27, 2025
Xov xwm tshaj plaws
Daim Ntawv Qhia Txog Tus Cwj Pwm Tshiab Kev Noj Qab Haus Huv (BHSA) Kev Txhawb Nqa Nyiaj Tau Los thiab Kev Npaj
DHCS released the BHSA Revenue Stability Workgroup Report with recommendations to reduce the variance of county Behavioral Health Services Funds (BHSF). The recommendations are intended to help counties manage revenue more consistently, maintain services through economic ups and downs, and bring greater predictability and accountability to local behavioral health care funding.
The BHSA Revenue Stability Workgroup, comprising state leaders and counties, was required to develop and recommend solutions to reduce BHSA revenue volatility and propose appropriate prudent reserve levels to support the sustainability of county programs and services. It reviewed and analyzed current and historical revenues generated by the MHSA and the BHSA and prudent reserve levels to develop the recommendations.
The State Controller’s Office will continue to follow the current process to distribute BHSA local assistance funds to counties monthly. The goal is to balance local assistance revenue allocation and program stability, helping counties effectively plan and provide critical behavioral health services during revenue downturns. Highlights include:
- Kev siv nyiaj txhua xyoo raws li qhov nruab nrab peb xyoos, hloov kho rau kev nce nqi.
- Tshiab txwv txwv (10-15 feem pua, nyob ntawm lub nroog loj).
- Ib zaug yuav tsum tau siv nyiaj ntau dhau ntawm 2026-2029.
- Yooj yim los kho cov peev nyiaj yog tias cov nyiaj tau los poob.
- Ntau pob tshab, nrog rau kev tshaj tawm pej xeem thiab cov tswv yim hauv zej zog.
This approach supports California’s Mental Health for All vision by promoting stability, transparency, and community-centered behavioral health care. State legislation is required to enact recommendations from the BHSA Revenue Stability Workgroup Report.
Kev Pabcuam Hauv Zej Zog Qhia Txog Tus Nqi Thaum Ntxov Thaum Ua Raws Li Medi-Cal Cov Tswv Cuab xav tau
DHCS recently submitted to the Centers for Medicare & Medicaid Services (CMS) its Community Supports, or In Lieu of Services (ILOS), Annual Report[TO1] , which reviews the progress and impact of Medi-Cal Community Supports in 2024. For the first time, the report also includes a cost-effectiveness analysis for 2023. The report highlights key achievements, such as reduced emergency room visits, hospitalizations, and long-term care use, pointing to early evidence of both improved health outcomes and reduced costs when compared to the services they are replacing, such as inpatient, emergency department, and long-term care services. Of the 12 Community Supports studied, nine are already proving cost-effective, and the remaining three are expected to prove to be cost-effective over time.
The report also outlines operational improvements made by DHCS and managed care plans (MCP) to expand services, grow provider networks, and support implementation. While progress has been significant, the report also identifies ongoing challenges and opportunities for further improvement, ensuring these services continue to evolve to meet the needs of Medi-Cal members.
Kev hloov kho tshiab
Medi-Cal Kev Lag Luam MCP Kev Muag Khoom Hloov Tshiab
DHCS yuav ncua qhov kev yuav khoom Medi-Cal MCP tom ntej tsawg kawg yog ob xyoos. Qhov kev sib tw yuav khoom rau MCPs tom ntej yuav pib tsis pub dhau xyoo 2029, nrog rau cov ntawv cog lus yuav pib siv tsis pub dhau xyoo 2031. DHCS tau qhia ua ntej lawm tias kev yuav khoom dua rau cov MCPs lag luam yuav raug ua ib zaug txhua tsib xyoos. Raws li lub sijhawm teem tseg no, DHCS yuav tsum tau tso tawm Daim Ntawv Thov Kev Pom Zoo (RFP) hauv xyoo 2027 rau hnub cog lus uas siv tau rau lub Ib Hlis 1, 2029.
The additional time will allow DHCS to focus on critical California Advancing and Innovating Medi-Cal (CalAIM) initiatives. It will also help maintain stability for members and support ongoing improvements to care quality and access, while also supporting the long-term success of the Medi-Cal managed care program.
In accordance with current policy, MCP contracts will be renewed annually following the contractual requirements identified in Exhibit E, 1.1.15 of the 2024 Managed Care Boilerplate Contract. Current MCP contracts will be extended from January 1, 2026, to December 31, 2026, by the established annual process. DHCS remains committed to fostering an inclusive, flexible, and responsive process that supports the Medi-Cal program and ensures continued equitable access to high-quality care for Californians. Please visit the Medi-Cal Managed Care webpage for more information.
Kev Hloov Kho Hniav Tswj Kev Kho Hniav
During the week of May 26, DHCS will mail a 30-day notice to about 350,000 Medi-Cal members in Sacramento and Los Angeles counties to notify them of upcoming changes to their dental service delivery, effective July 1, 2025. The member notice explains what is changing, if the member needs to make a plan choice, the member’s continuity of care protections, and other important information, and will include a Medi-Cal managed care enrollment packet.
Members in Sacramento County who are currently enrolled in Access Dental Plan or dental fee-for-service (FFS) must select a new Dental Managed Care plan, while members in Los Angeles County who do not choose a Dental Managed Care plan will remain in FFS. Members currently enrolled with Health Net or Liberty will not be affected by these changes. Additionally, changing Dental Managed Care plans will not affect Medi-Cal coverage or benefits.
Medi-Cal Health Care Options tab tom ua ib qho kev sib tham hu xov tooj rau cov tswv cuab uas tau txais pob ntawv sau npe rau kev saib xyuas kev kho mob. Thaum lub sijhawm hu xov tooj no, cov neeg sawv cev ntawm HCO yuav tshuaj xyuas cov kev xaiv ntawm txoj kev npaj kho hniav uas muaj, teb cov lus nug, thiab pab txhawb kev sau npe rau hauv txoj kev npaj uas tus tswv cuab xaiv los ntawm xov tooj. DHCS tau tsim nplooj ntawv web Dental Transition Member Notices rau cov tswv cuab kom saib cov ntawv ceeb toom thiab lwm cov ntaub ntawv hais txog kev hloov pauv Dental Managed Care.
Medi-Cal Requirements thiab Cov txheej txheem rau npe rau cov kws kho mob
Txij li Lub Yim Hli 1, 2025, cov chaw muab tshuaj uas tuav daim ntawv pov thawj Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver thiab daim ntawv pov thawj California Clinical Laboratory Registration tam sim no yuav them nqi rau cov kev kuaj mob CLIA-waived uas muab rau hauv qhov kev xyaum ntawm tus kws muag tshuaj raws li tau txhais los ntawm California State Board of Pharmacy thiab tau tso cai hauv Business and Professions Code Section 4052.4. Cov kws muab tshuaj yuav tsum thov rau npe rau hauv qhov kev pab cuam Medi-Cal los ntawm kev xa daim ntawv thov rau npe rau tus kws muab tshuaj Medi-Cal online, nrog rau txhua cov ntaub ntawv txhawb nqa.
On June 10, from 10 to 11 a.m. PDT, DHCS will hold a public stakeholder hearing via webinar (advance registration required) to discuss the draft regulatory provider bulletin entitled, “Medi-Cal Enrollment Requirements and Procedures for Pharmacy Providers that Hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.”
Cov lus tawm tswv yim, cov lus nug, lossis cov lus qhia sau tuaj yeem xa tuaj thaum lub rooj sib hais hauv kev sib tham hauv webinar. Rau cov neeg uas tuaj koom tsis tau, cov lus sau yuav tsum xa tuaj ua ntej 5 teev tsaus ntuj PDT rau lub Rau Hli 10 kom txiav txim siab tshaj tawm. Thaum xa cov lus tawm tswv yim sau ua ntawv, thov xyuas kom meej tias tus neeg tawm tswv yim thiab lub koom haum/koom haum uas sawv cev rau tau txheeb xyuas hauv cov lus tawm tswv yim. Thov xa cov lus tawm tswv yim sau ntawv mus rau DHCSPEDStakeholder@dhcs.ca.gov. Raws li cov lus tawm tswv yim ntawm pej xeem tau txais, DHCS yuav tshaj tawm tsab ntawv xov xwm kawg rau ntawm cov chaw muab kev pabcuam Medi-Cal thiab DHCS Provider Enrollment Division lub vev xaib.
Koom nrog peb pab neeg
DHCS tab tom nrhiav ib tus neeg muaj peev xwm thiab muaj kev txhawb siab los ua haujlwm xws li:
- Chief, Capitated Rates Development Division. Tus Thawj Coj yog tus thawj coj kev teeb tsa tus nqi rau Medi-Cal cov phiaj xwm saib xyuas thiab Cov Kev Pabcuam Txhua-Inclusive Care rau Cov Neeg Laus. Cov dej num suav nrog kev siv cov txheej txheem actuarial los tsim cov nqi capitation thiab saib xyuas kev txhim kho thiab kev siv cov cai thiab cov txheej txheem rau kev them nyiaj rov qab. Tsis tas li ntawd, Tus Thawj Saib Xyuas kom paub meej txog cov txheej txheem nyiaj txiag ua raws li kev xa khoom zoo ntawm kev saib xyuas kev noj qab haus huv thiab ua raws li lub xeev thiab tseemfwv txoj cai lij choj, cov cai, thiab cov cai. Cov ntawv thov yuav tsum xa ua ntej lub Tsib Hlis 30.
- Tus Lwm Thawj Coj (ADD), Kev Pabcuam Tshuab Lag Luam (ETS). Lub luag haujlwm ADD tshiab no yuav tsim kev sib raug zoo ua haujlwm nrog DHCS Cov Neeg Ua Haujlwm, cov neeg koom tes hauv kev pab cuam, thiab cov neeg koom tes sab nraud, thiab pab nrog kev coj ua ntawm DHCS cov kev pab cuam thiab cov kev pabcuam IT. Tsis tas li ntawd xwb, ADD yuav ua lub luag haujlwm tseem ceeb hauv kev coj ua txoj kev tsim thiab kev siv cov cai IT, kev tsim qauv ntawm lub kaw lus, kev ruaj ntseg, kev txhim kho, thiab kev daws teeb meem rau DHCS cov kev pab cuam, suav nrog Medi-Cal thiab kev noj qab haus huv ntawm tus cwj pwm. Cov ntawv thov yuav tsum xa tuaj rau lub Rau Hli 2.
DHCS tab tom nrhiav neeg ua haujlwm rau nws txoj kev saib xyuas Medi-Cal, kev tshuaj xyuas cov ntaub ntawv, kev tsim nyog Medi-Cal, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib lub vev xaib CalCareers.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
DHCS posts upcoming public meetings on the 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.
Kev Pabcuam Ambassador Webinar Series: Birthing Care Pathway
On May 29, from 11 a.m. to 12 p.m. PDT, DHCS will hold a Coverage Ambassador webinar that will focus on DHCS’ Birthing Care Pathway initiative (advance registration required). The webinar will provide information about maternity services for pregnant and postpartum Medi-Cal members from conception through 12 months postpartum and review highlights from the Birthing Care Pathway Report released on February 4. This initiative helps to ensure Medi-Cal members have access to high-quality, equitable care to improve maternal health outcomes and reduce disparities. Coverage Ambassadors will also learn about DHCS’ social media platforms, which offer up-to-date information on relevant topics that can benefit both Coverage Ambassadors and Medi-Cal members. Simultaneous interpretation in Spanish will be offered during the webinar.
Hauv Case Koj Tsis Tau Nws
Thov rau Daim Ntawv Thov (RFA): Cov Kev Pabcuam Vaj Tse yooj yim
On May 7, DHCS announced the Flexible Housing Subsidy Pools (“Flex Pools”) RFA. DHCS will select up to 10 local teams to participate in the Flex Pools TA Academy and receive Flex Pools planning grants of approximately $150,000. The launch of Medi-Cal Transitional Rent and Behavioral Health Services Act (BHSA) Housing Interventions creates an unprecedented opportunity to help people achieve better health outcomes through housing stability.
Flex Pools are intended to help counties and Tribal entities improve housing stability for individuals experiencing or at risk of homelessness. They are a locally designed model to coordinate rental assistance and make the best use of available housing supports, aligning the work of managed care plans, county behavioral health agencies, and other key partners in the homeless services and rehousing systems. Applications are due to DHCS by 5 p.m. PDT on June 13, 2025. Organizations selected will be notified in July 2025. To learn more and apply, please visit the DHCS Housing for Health website.
HCBA Waiver Amendment Application – 30-Hnub Public Comments Period
Thaum Lub Tsib Hlis 12, DHCS tau tshaj tawm daim ntawv qauv ntawm 2025 Home and Community-Based Alternatives (HCBA) kev hloov kho rau 30 hnub rau pej xeem tawm tswv yim, ua ntej xa daim ntawv kawg rau CMS kom rov tso cai dua. Daim ntawv tso cai HCBA tso cai rau cov neeg sau npe tsim nyog tau txais cov kev pabcuam pom zoo los ntawm lub tshuab xa khoom hauv xov tooj. Cov kev hloov pauv uas tau pom zoo hauv kev hloov kho kev zam txim suav nrog:
- Qhia kom meej cov kev taw qhia thiab kev cia siab rau cov kev pabcuam telehealth.
- Tshem tawm Cov Chaw Kho Mob Nruab Nrab rau Kev Kho Mob Tsis Muaj Kev Kho Mob Nruam (ICF/DD-CN) uas tsis yog qhov cua thiab qhov cua-dependent cov txiaj ntsig thiab kev teeb tsa, vim lawv tab tom hloov mus rau Medicaid State Plan raws li cov txiaj ntsig kev saib xyuas mus sij hawm ntev.
This transition advances California’s efforts to comply with the federal Medicaid Home and Community-Based Settings (HCBS) Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy.
DHCS caw txhua tus neeg uas xav paub txog qhov kev hloov kho thiab cov lus qhia tawm tswv yim ntawm nplooj ntawv web DHCS HCBA Waiver nyob rau hauv Daim Ntawv Thov Hloov Kho HCBA Waiver - 30-Hnub Cov Lus Qhia rau Pej Xeem txij lub Tsib Hlis 12, 2025 - Lub Rau Hli 12, 2025 . Txhua cov lus tawm tswv yim yuav tsum tau txais los ntawm Lub Rau Hli 12, 2025. Yog koj muaj lus nug dab tsi, thov xa email rau hcbspolicy@dhcs.ca.gov.
Medicaid State Plan Amendment (SPA) – 30-hnub Public Comments Period
On May 12, DHCS posted the ICF/DD-CN: Transition of Benefit/Setting SPA (SPA #25-0026) for a 30-day public comment period, prior to submitting the final version to CMS for approval. ICF/DD-CNs provide 24-hour personal care, developmental services, and nursing supervision for individuals with developmental disabilities who have continuous needs for skilled nursing care and have been certified by a physician and surgeon as warranting continuous skilled nursing care. This service is currently provided through the HCBA waiver. This SPA will transition the ICF/DD-CN benefit/setting from the HCBA waiver to the Medicaid State Plan as a long-term care setting. This transition advances California’s efforts to comply with the federal HCBS Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy. All comments must be received by June 12, 2025. If you have any questions, please email PublicInput@dhcs.ca.gov.