The Department of Health Care Services’ (DHCS) Medi-Cal Program is required to seek advice from Tribes and designees of Indian Health Programs and Urban Indian Organizations on Medi-Cal matters having a direct effect on Indians, Indian Health Programs or Urban Indian Organizations per the American Recovery and Reinvestment Act of 2009 (ARRA).   DHCS must solicit the advice of tribes and designees of Indian health programs prior to submission to Centers for Medicare and Medicaid Services (CMS) of any State Plan Amendment (SPA), waiver requests, waiver renewals, or waiver modifications, or proposals for demonstration projects in the Medi-Cal program.  Proposed changes to the Medi-Cal program are submitted quarterly to CMS for approval.
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Cov xeev tau txais kev taw qhia txog kev ua raws li ARRA qhov yuav tsum tau ua los ntawm State Medicaid Directors Letter 10-001​​ 

CMS tau pom zoo rau DHCS cov txheej txheem rau kev nrhiav tswv yim txog kev hloov pauv rau Medi-Cal qhov kev pab cuam raws li tau teev tseg hauv SPA 12-002​​ 

DHCS coj kev sib txuas lus txog kev hloov pauv rau Medi-Cal qhov kev pab cuam raws li tau teev tseg hauv SPA 12-002 rau cov pab pawg hauv qab no:​​ 

• Cov npe tam sim no ntawm Indian Health Program Designees​​ 
• Cov npe tam sim no ntawm California Tribal Chairpersons​​