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When it enacted H.R. 1, the federal government made it more difficult for individuals to get basic health care. CMS then issued a rule that went further and would have made it even harder for the most medically vulnerable to qualify for Medicaid.
But, on October 29, 2026, at the urging of California and other states, a federal court determined that CMS had unlawfully exceeded its authority by creating additional requirements for individuals to be able to meet the medical frailty exemption from the new work and community engagement requirements. The court’s decision affirms that CMS cannot create additional obstacles to obtaining Medicaid for the most medically vulnerable that appear nowhere in the statute.
California remains committed to helping eligible Medi-Cal members obtain and maintain coverage while complying with federal law. We will continue working with counties, health plans, providers, community organizations, and federal partners to support an orderly implementation of H.R. 1 and provide members with clear information about any program changes.
Consistent with our longstanding approach, DHCS is focused on minimizing unnecessary coverage losses and maintaining access to affordable, integrated, and high-quality health care for Californians.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
SACRAMENTO — California is partnering with 112 community organizations to help prevent opioid and stimulant use, reduce overdose risk, and connect people to treatment and recovery services. Through the Department of Health Care Services’ (DHCS) Opioid and Stimulant Use Disorder Prevention and Education Program, which is investing more than $21 million statewide, trusted community organizations will provide outreach and education, distribute naloxone, host workshops, offer peer navigation, and strengthen local connections to treatment and recovery services.
“California is acting with urgency to save lives and strengthen communities. By partnering with local organizations that people know and trust, we are expanding prevention, education, and pathways to treatment so more Californians can get help and heal. Every life saved matters, and we are all in on solutions that reduce overdoses and connect people to care.” ~ Governor Gavin Newsom
Nearly a third of all adults in the United States know someone who has died of a drug overdose, and nearly half of all adults have a family member or close friend who has been or is currently addicted to drugs. To fight this epidemic, we must reduce stigma around treatment and recovery, improve accessibility to evidence-based services and local resources, and ensure our communities understand addiction and substance use disorders. The Opioid and Stimulant Use Disorder Prevention and Education Program has shown significant progress in these efforts. In one year, from September 2024 to September 2025:
The partnerships and investments announced today advance California’s statewide work to prevent overdose deaths through preventative education, treatment, recovery, and community-based supports. From September 1, 2026, through August 31, 2027, awarded organizations will implement activities tailored to the needs of their communities, including:
“These investments empower local partners to meet people where they are, reduce stigma, and open doors to vital services,” said Department of Health Care Services Director Michelle Baass. “When communities have the tools to educate, engage, and navigate people to treatment and recovery, we make measurable progress against opioid and stimulant harms.”
The Opioid and Stimulant Use Disorder Prevention and Education Program is funded through the State Opioid Response (SOR) IV grant awarded by the Substance Abuse and Mental Health Services Administration. The SOR grant program provides resources to fight the opioid overdose crisis by increasing access to FDA-approved medications for the treatment of opioid use disorder and supporting the continuum of prevention, treatment, and recovery support services for opioid use disorder and other concurrent substance use disorders.
The overdose epidemic claims thousands of lives each year throughout the nation — and California is combating this through an all-hands-on-deck approach. A critical component of that is overdose prevention services and methods like naloxone, which is capable of reversing opioid overdoses swiftly and effectively.
The state is offering CalRx-branded over-the-counter naloxone at a significantly lower price, while eligible California entities can receive free naloxone kits from the Naloxone Distribution Project, whose kits have reversed over 460,000 overdoses.
Among other actions and legislation focused on addressing and treating the opioid crisis, in 2022, the Governor signed SB 184, which requires treatment facilities to either offer MAT directly to clients or have an effective referral process in place with narcotic treatment programs, community health centers, or other MAT providers. In 2024, he signed AB 2376 (Bains) to increase the number of hospital beds available for the treatment of substance use disorder, including MAT, by giving facilities new flexibility in managing their treatment slots. There are a number of projects focused on expanding MAT access, including the Tribal MAT Project, MAT Access Points, the California Hub & Spoke System, and more.
The state is also taking aggressive action to target fentanyl trafficking and disrupt the supply of deadly illicit drugs in the state, including partnering with local law enforcement and expanding the California National Guard’s role in drug interdiction across the state and at the border.
If you or someone you know needs help: call 1-800-944-1807 or text 1-833-308-0461, Monday through Friday, 9 AM to 5 PM. For more information on opioids and how you can protect yourself and loved ones, visit Opioids.CA.GOV, a one-stop shop for Californians seeking resources on prevention and treatment.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
Prop 1 delivering more beds and more treatment slots, ahead of schedule
What you need to know: After historic drops in homelessness, Governor Newsom’s landmark reform of California’s behavioral health system has reached an important milestone: the opening of the first behavioral health facility built with voter-approved Proposition 1 funding — ahead of schedule. In the two years since voters approved the measure, the state has already delivered 102% of the beds and 104% of the treatment slots promised.
SAN RAFAEL – As California’s homelessness drops for a second year, Governor Newsom’s transformation of the mental healthcare system continues delivering by connecting people with behavioral health care, addiction services, and keeping people off the streets. Through Proposition 1, which the Governor championed and voters approved in 2024, California is expanding treatment capacity faster than promised — delivering 6,948 residential treatment beds and 27,868 outpatient slots.
Today, the Governor announced that the first behavioral health facility funded by Proposition 1, the Ritter Center in San Rafael, is now open, with 1,412 outpatient treatment slots projected to serve more than 7,000 individuals annually. The facility is funded through Prop 1’s Behavioral Health Continuum Infrastructure Program (BHCIP) Bond, which has already funded 176 projects across 334 facilities for local communities.
When I took office, I committed to creating a statewide strategy to help move people off our streets and into housing and treatment. Over the course of this administration, we’ve built that framework — and we’re delivering results, including the largest two-year drop in homelessness in over a decade.
“In 2024, voters demanded action, results, and accountability with the passage of Prop 1. Today’s announcement is another major step in reversing a crisis decades in the making, and we’re just getting started. We now have more than 100% of the beds and treatment slots we promised to voters, ahead of schedule.
Governor Gavin Newsom
A b-roll package can be downloaded here.
This announcement is the next step in strengthening the continuum of care and reducing homelessness, but it is only the beginning. The state expects to open 13 more Behavioral Health Continuum Infrastructure Program (BHCIP)-funded facilities by the end of 2026, with all construction complete by 2028 — and hundreds more are on the way.
The Ritter Center is the first Bond BHCIP Round 1 project to begin serving Californians; with a community mental health clinic, office-based opioid treatment, and outpatient substance use disorder services. The Ritter Center is the first of hundreds of new facilities expected to open in the coming years.
“This s what meaningful progress looks like: new facilities opening their doors, more treatment options becoming available, and more Californians getting connected to the care they need,” said California Health and Human Services Agency Secretary Kim Johnson. “We are making significant strides toward building a stronger, more accessible behavioral health system that better serves individuals and families across California.”
Bond BHCIP continues to exceed statewide capacity targets:
Bond BHCIP builds upon the foundation of the earlier BHCIP initiative, with projects funded through the state budget prior to Prop 1. Since 2021, BHCIP has awarded a total of $6.1 billion to expand behavioral health infrastructure. This has resulted in 436 projects across 543 behavioral health facilities, which will create 9,570 new beds and 44,863 new outpatient slots projected to serve more than 5.4 million individuals annually. Together, these efforts strengthen the state’s long term community based behavioral health infrastructure.
Recent efforts span prevention, youth services, housing, reentry supports, and investments in the behavioral health workforce. These investments aim to reverse decades-old gaps in care, reduce homelessness, and keep Californians with serious behavioral health needs out of the criminal justice system through a stronger, more coordinated statewide treatment system.
Bond BHCIP projects undergo extensive review before receiving a conditional award and must continue to meet program and funding requirements before the Department of Health Care Services (DHCS), which administers the program, finalizes funding. The state maintains rigorous standards to ensure projects are sustainable and positioned for long-term success.
The Governor is also today announcing new accountability actions, reinvesting more than $146 million in Bond BHCIP funding for three behavioral health projects in Los Angeles and Shasta counties, ensuring voter-approved investments continue to expand behavioral health infrastructure throughout California. This funding now supports three additional projects:
“Every BHCIP project reflects the commitment of local communities and partners to strengthen California’s behavioral health system,” said DHCS Director Michelle Baass. “We are expanding access to care while ensuring public dollars are used responsibly and effectively.”
Proposition 1 and BHCIP fit within a broader behavioral health strategy, Mental Health for All, which reflects California’s continued commitment to responsibly invest public dollars to strengthen the state’s behavioral health system. Launched under Governor Newsom’s leadership, this bold initiative is building a stronger, more equitable, and more accountable behavioral health system for Californians across their lifespans.
From addressing the crisis of loneliness in young men through the state’s Path and Purpose Initiative, strengthening tools like the 988 suicide and crisis lifeline, expanding community mental health supports, building stronger prevention strategies, improving reentry through more robust reentry strategies, building more housing and support, creating stronger trauma and crisis response for children, investing in California’s behavioral health workforce, and establishing a first-in-the-nation CARE Court process to help people with severe mental illness get treatment, Governor Newsom is repairing a broken system that has suffered from decades of neglect.
This neglect began under then-Governor Reagan’s administration, when state hospitals were closed, and no adequate alternative was provided, leaving people most in need of help to fall into the criminal justice system or homelessness. This created a generational impact.
Today, across California, individuals with untreated psychosis are 10 times more likely to experience homelessness and 16 times more likely to be incarcerated. Through the many programs and strategies of California’s strong behavioral health continuum, the state is turning this crisis around.
Governor Newsom is the first Governor to make addressing homelessness — an issue decades in the making — a top priority. Since taking office in 2019, the Governor has created unprecedented policy and structural changes in state government to help California better address its housing and homelessness crises, including additional and unprecedented support for local governments, stronger accountability and enforcement, transformational changes to mental health services and state government, and groundbreaking reforms to create more housing, faster than ever before.
Together, these efforts have helped California achieve a two-year drop in homelessness, with preliminary estimates showing unsheltered homelessness declining for the second consecutive year — down nearly 13% since 2024.
Californians can track how their community is addressing mental health, homelessness, and housing at accountability.ca.gov.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
SACRAMENTO —The Department of Health Care Services (DHCS) today announced a major advancement in statewide behavioral health transparency with the release of the Behavioral Health Public County Profile, California’s first public-facing, statewide tool to combine county-reported behavioral health data in a single, accessible resource. The profile enables the public, policymakers, and stakeholders to easily compare counties’ behavioral health planning, funding, service delivery, and progress toward statewide goals.
The profile reflects the culmination of two years of work under Proposition 1 and the Behavioral Health Services Act (BHSA), with DHCS working closely with counties to produce, validate, and standardize the information included in the profile. The release of the profile follows California’s transition on July 1, 2026, from the Mental Health Services Act to the new BHSA, which strengthens statewide accountability by aligning county investments with statewide goals for equity, outcomes, and transparency.
“By making data accessible and in one place, we are giving people the tools to see what’s working, where the gaps are, and how we can build a system that delivers care, dignity, and hope for everyone,” said Governor Gavin Newsom. “Knowledge is power, and we are far from powerless.”
“California set out to build one place where the public can clearly see how our behavioral health system is functioning at the local level, and this tool delivers on that vision,” said DHCS Director Michelle Baass. “The profile brings together complex data in a format that’s easy to understand, supporting more informed statewide and local conversations about how to advance behavioral health services.”
WHAT’S NEW: The profile increases transparency by integrating county demographics and behavioral health data, with exportable information from the counties’ three-year BHSA Integrated Plans, including program investments. After counties submitted their required integrated plans — three-year roadmaps for behavioral health services, programs, and investments — DHCS quickly processed and published county materials to provide a clear picture of county behavioral health priorities, projected expenditures across BHSA funding sources, and anticipated numbers served. The profile also includes:
Together, this information provides Californians with the clearest statewide picture to date of county behavioral health systems, performance, and planned investments.
WHY THIS MATTERS: The profile marks a major milestone in California’s effort to increase transparency and accountability under the BHSA. It makes county behavioral health data publicly accessible in a single dashboard, including demographics, homelessness and housing-related behavioral health services, Integrated Plan information, and performance measures, so Californians can see how local resources are allocated and how county performance compares statewide. Policymakers and stakeholders can use these data to strengthen oversight, monitor progress toward statewide goals, and inform future investments. This initiative is a core deliverable of California’s Mental Health for All modernization, advancing equitable access, accountability, and outcomes by making county behavioral health data transparent and actionable statewide.
LOOKING AHEAD: California will continue enhancing the profile in the coming year, adding more datasets, new reporting tools, and an expanded suite of performance measures. These enhancements will provide an increasingly comprehensive view of California’s behavioral health system and help the state and counties measure progress, identify opportunities for improvement, and strengthen services for Californians.
LEARN MORE: To explore county data and statewide progress, visit the Behavioral Health Public County Profile. For questions, please email BHTinfo@dhcs.ca.gov.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
| What you need to know: Governor Newsom today launched CA Bridge Connect, a free statewide call- and text-based service offering immediate help and support to Californians seeking treatment for opioid use. This is part of California’s “no wrong door” approach to care, as we build a system that gives everyone access to the services and resources they need to get back on their feet and live a healthy life. To get help, call (800) 944-1807 or text (833) 308-0461. |
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| SACRAMENTO — Governor Gavin Newsom today launched CA Bridge Connect, a free statewide call- and text-based service offering immediate help and support to Californians seeking treatment for opioid use. This is part of a broader strategy to take on the opioid and overdose epidemic, which includes expanding access to addiction treatment. “CA Bridge Connect makes it easier for Californians to find the right help, at the right time, so more people can begin treatment and take their next step toward recovery.” ~Governor Gavin Newsom The confidential helpline serves people seeking help, families, caregivers, and clinicians, regardless of insurance coverage. People reaching out can get same-day referrals to Behavioral Health Navigators who can assess a person’s needs; coordinate real-time referrals to clinics, emergency departments, community providers, and telehealth providers; and, when appropriate, prescribe Medication for Addiction Treatment (MAT), an evidence-based approach to treating opioid use disorder. “CA Bridge Connect further enforces our commitment to ensuring Californians have access to timely substance use treatment when and where they need it,” said Department of Health Care Services (DHCS) Director Michelle Baass. “We are building a system that prioritizes care, dignity, and recovery.” When someone is ready to seek treatment for opioid use disorder, help should be easy to find and easy to access. CA Bridge Connect gives Californians a direct, same-day route to lifesaving care. This access to evidence-based treatment, including MAT, is vital to preventing overdoses and improving health outcomes. “CA Bridge Connect partners with addiction treatment providers across the State who have truly embraced compassionate, evidence-based addiction care,” said Arianna Campbell, DMSc, MPH, PA-C, co-founder of CA Bridge. “Accessing treatment can be difficult in fragmented health systems. Through strong clinical partnerships and dedicated Behavioral Health Navigators, we are committed to making it easier for anyone to access care quickly. No one should face addiction alone.” No wrong door to care California takes a “no wrong door” approach to care, building a system that gives everyone access to the services and resources they need to get back on their feet and live a healthy life. CA Bridge Connect offers Californians another entry point to care, building on a longstanding partnership with the Public Health Institute’s CA Bridge program, the country’s largest emergency department-based opioid addiction treatment model. CA Bridge launched in 2018 to expand low-barrier access to MAT, supporting hospitals, street medicine teams, and community-based providers in helping Californians access evidence-based care immediately. California’s approach to care proves that people struggling with addiction want help — it just has to be accessible. Forty percent of patients offered treatment in the emergency department accepted, and when they saw a substance use navigator, that number rose to 85%. Even patients coming to the emergency department for issues unrelated to their substance use accepted treatment when it was offered more than half of the time. Both CA Bridge and CA Bridge Connect are simplified entry points to care, supporting statewide efforts to reduce barriers, expand treatment access, and strengthen connections across California’s behavioral health system. DHCS partnered with California-based 988 crisis call centers and the Addiction Treatment Locator, Analysis and Standards (ATLAS) treatment locator to add CA Bridge Connect as a resource within those systems. Addressing the opioid and overdose epidemic The overdose epidemic claims thousands of lives each year throughout the nation — and California is combating this through an all-hands-on-deck approach. A critical component of that is overdose prevention services and methods like naloxone, which is capable of reversing opioid overdoses swiftly and effectively. The state is offering CalRx-branded over-the-counter naloxone at a significantly lower price, while eligible California entities can receive free naloxone kits from the Naloxone Distribution Project, whose kits have reversed over 460,000 overdoses. Among other actions and legislation focused on addressing and treating the opioid crisis, in 2022, the Governor signed SB 184, which requires treatment facilities to either offer MAT directly to clients or have an effective referral process in place with narcotic treatment programs, community health centers, or other MAT providers. In 2024, he signed AB 2376 (Bains) to increase the number of hospital beds available for the treatment of substance use disorder, including MAT, by giving facilities new flexibility in managing their treatment slots. There are a number of projects focused on expanding MAT access, including the Tribal MAT Project, MAT Access Points, the California Hub & Spoke System, and more. The state is also taking aggressive action to target fentanyl trafficking and disrupt the supply of deadly illicit drugs in the state, including partnering with local law enforcement and expanding the California National Guard’s role in drug interdiction across the state and at the border. If you or someone you know needs help: call 1-800-944-1807 or text 1-833-308-0461, Monday through Friday, 9 AM to 5 PM. For more information on opioids and how you can protect yourself and loved ones, visit Opioids.CA.GOV, a one-stop shop for Californians seeking resources on prevention and treatment. |
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FOR IMMEDIATE RELEASE
Tuesday, August 25, 2026
Governor’s Press Office: (916) 445-4571
Temporary Funding Withholds Reinforce Accountability for County Behavioral Health Plans that Failed to Meet State and Federal Provider Network and Timely Access Standards
SACRAMENTO —The Department of Health Care Services (DHCS) today announced new enforcement actions holding county Behavioral Health Plans (BHP) accountable to improve behavioral health access for Medi-Cal members. DHCS is implementing temporary funding withholds for 10 county BHPs that have not corrected repeated deficiencies in meeting state and federal standards for having enough providers to meet the needs of Medi-Cal members and/or ensuring timely access to behavioral health care.
“When someone needs help, waiting carries real consequences. Every day without care is a day of fear, confusion, and suffering that could have been eased. Care should meet people where they are: on time, close to home, and without hoops to jump through,” said DHCS Director Michelle Baass. “People deserve a path that is simple, steady, and kind, because mental health care isn’t paperwork, it’s help in the moment it matters.”
WHY THIS IS IMPORTANT: County BHPs are required to meet network adequacy (having enough qualified providers in a BHP to meet the needs of Medi-Cal members) and provide timely access to care. Each year, DHCS measures BHPs’ network adequacy, including provider-to-member ratios, appointment wait times, and geographic access. For years, DHCS has provided technical assistance and imposed corrective action plans to help BHPs address gaps and deficiencies with meeting established standards. Temporary funding withholds represent the next step to hold plans accountable. As California transforms its behavioral health delivery system, timely access to care remains essential.
“For several years, California has emphasized that timely, high-quality care is not optional—it’s fundamental to Medi-Cal’s mission. While several counties have made meaningful progress, others continue to have targeted gaps that need to close,” said State Medicaid Director Tyler Sadwith. “These temporary withholds underscore our commitment to accountability and ensure that every county moves decisively toward building the provider networks Californians need. By enforcing clear expectations and supporting counties to meet them, we are advancing a system where every member can rely on timely, equitable behavioral health care.
WHAT THIS MEANS: DHCS will temporarily withhold a portion of behavioral health funding from BHPs that remain out of compliance with one or more network adequacy standards for two consecutive certification cycles (2024-25 and 2025-26). Funds will be returned once a BHP demonstrates compliance. BHPs with deficiencies will also move into enhanced monitoring, including regular progress reporting and ongoing technical support. The imposition of temporary withholds represents the beginning point of a graduated enforcement framework that allows for further escalation as warranted, including ongoing temporary withholds and permanent monetary sanctions.
HOW THIS IMPROVES CARE: Holding counties accountable for meeting access standards helps ensure Medi-Cal members receive timely, medically necessary behavioral health services. Strong provider networks reduce wait times, improve access to care close to home, and support California’s broader behavioral health transformation through the California Advancing and Innovating Medi-Cal (CalAIM) initiative and Mental Health for All. By strengthening county provider networks, DHCS is improving access to quality mental health and substance use disorder treatment.
FINDINGS: During the 2025-26 certification cycle, DHCS assessed BHPs against 43 Specialty Mental Health Services (SMHS) and 46 Drug Medi-Cal Organized Delivery System (DMC-ODS) standards. Ten BHPs did not resolve deficiencies over two or more years and will have funds temporarily withheld:
DHCS will return withheld funds once a plan corrects its deficiencies. These actions follow state law and DHCS policies in Behavioral Health Information Notice (BHIN) 25-023 and BHIN 25-013.
ONGOING WORKFORCE INVESTMENTS: Alongside enforcement, DHCS continues to invest heavily in expanding California’s behavioral health workforce. Through the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) workforce initiative, the state is investing $1.9 billion over five years to support training, recruitment, and retention of behavioral health providers. Also, the Department of Health Care Access and Information is advancing statewide workforce development through its five-year Workforce Education and Training (WET) plan. Counties can supplement statewide efforts through the Behavioral Health Services Act.
MORE INFORMATION: For more information, please see the 2025-26 Behavioral Health Network Adequacy Compliance Report on the DHCS Network Adequacy webpage.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
CMS is intensifying its actions against California’s in-home care system, affecting children and adults with significant disabilities and seniors who rely on these services to remain safely at home.
CMS has deferred an additional $646.4 million from in-home care, which keeps Medi-Cal members with disabilities in their homes and out of institutions. This follows a previous $1.1 billion deferral from May, bringing the total to $1.7 billion deferred.
CMS is punishing the state for growing the program to serve the Californians who need it. In-home care growth reflects intentional, federally encouraged expansion, not improper spending. Growth in eligibility, increased wages for caregivers, and support for higher-acuity members are all in line with longstanding federal policy. In essence, CMS now seeks to penalize California for what was CMS’ own policy.
California’s approach, which had been long approved by CMS, saves federal and state taxpayers money. One year of in-home care saves state and federal taxpayers approximately $100,000 per person annually versus nursing facility care. A 2020 California State Auditor report found no program integrity concerns and recommended increasing reimbursement rates to grow the in-home care provider workforce and reduce reliance on costly institutional care. California did exactly that.
California is calling on CMS to stop threatening care for California’s most vulnerable residents.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
SACRAMENTO —As a result of Governor Newsom’s reforms to modernize and expand California’s behavioral health system, the Yurok Tribe yesterday broke ground on the Wah-Sekw-Won Treatment Center (Yurok Health and Wellness), a new 53-bed inpatient residential treatment facility that will significantly expand access to culturally grounded behavioral health care for Yurok Tribal members, other Native Americans, and eligible residents throughout Humboldt County and the surrounding region.
Once complete, the center will help address longstanding gaps in behavioral health services, reducing the need for Tribal and community members to travel far from home for treatment by supporting recovery and wellness in the region. The project is supported by a $26 million, California voter-approved Bond Behavioral Health Continuum Infrastructure Program (BHCIP) Round 1: Launch Ready award.
“The Yurok community will soon have access to culturally grounded behavioral health care close to home when they need it most,” said Department of Health Care Services (DHCS) Director Michelle Baass. “Without this center, many Tribal and local community members must continue to travel long distances away from their family and support network for care.”
ABOUT THE WAH-SEKW-WON TREATMENT CENTER (YUROK HEALTH AND WELLNESS): Located near Weitchpec, the 26,000-square-foot Wah-Sekw-Won Treatment Center will include:
WHAT THEY’RE SAYING: “Today’s groundbreaking is more than the start of a building. It is the continuation of our commitment to healing, wellness, and sovereignty,” said Dr. Jacqueline Bae, Director of Health Services, Yurok Tribe (Yurok Health and Wellness Center). “The Wah-Sekw-Won Treatment Center will provide culturally grounded care that honors the strength, resilience, and traditions of the Yurok people. This investment will save lives, strengthen families, and uplift our entire region for generations to come.”
“We are meticulously planning every aspect of this effort to provide high-quality, culturally centered health care services that help individuals restore balance to their lives,” said Chairman of the Yurok Tribe Joseph L. James. “This facility will provide a broad range of supportive care services as part of an expanding, sovereign, community-driven behavioral health system.”
“I want to express sincere gratitude to Governor Gavin Newsom, the California Health and Human Services Agency, and the Department of Health Care Services for their strong commitment to advancing health care access and outcomes in Tribal communities,” said Yurok Tribe Vice Chair Rose Sylvia.
“We fully support the Yurok Tribe’s vision to construct and operate a Tribal wellness center,” said Connie Beck, Director of the Humboldt County Department of Health and Human Services. “This project will bring lasting, positive changes to the region.”
WHY THIS MATTERS: More than 1.2 million adults in California live with a serious mental illness, and 1 in 10 residents meet the criteria for a SUD. Persistent shortages of treatment facilities contribute to rising rates of homelessness and incarceration among people with behavioral health needs. Investments like the Wah-Sekw-Won Treatment Center (Yurok Health and Wellness) help fill these gaps. The project will also support local job creation by expanding the behavioral health workforce in the region, contributing to long-term community stability.
BIG PICTURE: This project is one of 177 statewide, funded through Bond BHCIP resources to support both immediate needs and long-term behavioral health. Administered by DHCS, Bond BHCIP helps communities build, acquire, and expand crisis, residential, and outpatient treatment facilities. To date, the program has supported 333 facilities, adding 6,919 new residential and inpatient beds and 27,561 outpatient treatment slots statewide, surpassing statewide goals just two years after passage. Since 2021, BHCIP has awarded $5.8 billion to strengthen behavioral health care access.
The Yurok Tribe also received awards through BHCIP Round 1: Crisis Care and Mobile Units ($200,000), BHCIP Round 2: Planning Grants ($150,000), nearly $8 million through BHCIP Round 4: Children and Youth, and $12 million through Bond BHCIP Round 2: Unmet Needs to further strengthen the Tribe’s behavioral health infrastructure. The Yurok Youth Center, which broke ground in April 2026, will develop four facilities dedicated to behavioral health services for children and youth, expanding outpatient behavioral health capacity and increasing access to care for thousands of individuals annually.
Backed by strong community partnerships, statewide investments, and new policies, California continues building a comprehensive, equitable behavioral health system that ensures people can access prevention, crisis support, treatment, and long-term recovery services.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
SACRAMENTO —The Department of Health Care Services (DHCS) today released the latest quarterly report on Enhanced Care Management (ECM) and Community Supports. These services help Medi-Cal members stay healthier and avoid other, costlier health care services, such as emergency department visits and hospital stays. These data from July through September 2025 (Q3 2025) and a recent report highlight the continued expansion and impact of these services for Medi-Cal members.
“The continued growth of ECM and Community Supports reflects the strength of our statewide partnerships and the dedication of the care managers, providers, and community organizations who show up for Medi-Cal members every day,” said DHCS Director Michelle Baass. “These services are strengthening stability, dignity, and health for members across the state.”
KEY FINDINGS FROM THE Q3 2025 REPORT:
ECM offers California’s highest level of care management, pairing members with a Lead Care Manager who coordinates physical, behavioral, and social services to support stability and improve health outcomes. Community Supports are cost-effective, optional services offered by Medi-Cal managed care plans that address health‑related needs, such as housing instability, nutrition, transitions from institutional care, and chronic condition management.
WHY THIS MATTERS: ECM and Community Supports are key pillars of California’s work to build a more coordinated, equitable, and prevention-oriented Medi-Cal system. These programs help members with complex needs connect to consistent, community‑based supports that stabilize health and reduce the need for higher levels of care. By emphasizing prevention and whole‑person care, ECM and Community Supports continue to improve health outcomes for Medi‑Cal members statewide.
Managed care plans have significantly expanded ECM provider networks, adding more providers serving adults at risk of long-term care and children and youth with the highest needs. DHCS continues to encourage plans to fully utilize contracted providers and ensure services are delivered at the appropriate level of intensity.
COST-EFFECTIVENESS AND LONG-TERM IMPACT: Findings from DHCS’ latest In Lieu of Services (ILOS) annual report show that Community Supports are helping members avoid costlier forms of care. The report studies service costs and utilization before and after members received at least one of the 12 Community Supports authorized as ILOS between January 2023 and June 2024. Ten of the 12 Community Supports studied are already demonstrating cost-effectiveness across applicable Medicaid State Plan service categories, such as emergency department visits, inpatient hospital stays, and nursing facility stays. Key findings include:
Early results underscore long-term value, demonstrating that investing in services that address social drivers of health not only improves member well-being, but also reduces costs across Medi-Cal’s delivery system. For more information, see this fact sheet.
ECM AND COMMUNITY SUPPORTS ARE HERE TO STAY: ECM is a statewide Medi-Cal managed care benefit for members with the most complex needs. Community Supports are also an option for state Medicaid programs, primarily grounded in federal Medicaid managed care regulations and memorialized in approved managed care contracts. Because these services are built into the core structure of Medi-Cal managed care—not temporary pilots—DHCS will continue to oversee implementation, expand provider networks, and support long-term program stability.
This permanency ensures that members, care managers, providers, and community partners can continue investing in relationships and care models that make ECM and Community Supports effective. It also guarantees continuity of intensive care coordination, housing and nutrition supports, behavioral health services, and other critical resources relied upon by hundreds of thousands of Californians.
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Office of Communications
(916) 440-7660
DHCSPress@dhcs.ca.gov
SACRAMENTO — The federal Centers for Medicare & Medicaid Services (CMS) has taken the extraordinary step of deferring $1.1 billion in federal funding tied to California’s In-Home Supportive Services (IHSS) program.
This action sends a troubling message about the value CMS places on the essential work IHSS caregivers perform every day and creates significant fiscal strain for California, as the State continues ensuring uninterrupted care for more than 900,000 older adults, people with disabilities, and children who rely on IHSS to live safely at home.
IHSS is a federally approved Home and Community-Based Services (HCBS) program and a cornerstone of California’s long-standing efforts to keep people safe at home and out of costly institutional settings, an approach CMS has consistently encouraged for decades. California has built one of the nation’s strongest HCBS systems, expanding access to in-home services in direct alignment with federal policy and the Americans with Disabilities Act’s mandate to support individuals in the most integrated setting appropriate.
“CMS has used what once was a routine payment reconciliation process with states to undermine exactly what federal HCBS policy has long sought to achieve: helping more people remain safely at home, rather than enter institutions for long-term care,” said State Medicaid Director Tyler Sadwith.
CMS asked why IHSS expenditures have grown in recent years. California immediately explained there are three main factors that have driven increases in IHSS program costs:
The IHSS caseload for individuals eligible for federal financial participation Medi-Cal increased from 613,764 in State Fiscal Year (SFY) 2022-23 to 720,988 in SFY 2024-25, a 17.5 percent increase. The average cost per hour went from $19.00 to $21.03 in the same period, representing an increase of 10.7 percent driven by statewide minimum wage increases and county-negotiated wage rates. Wage increases are a tool to recruit and retain qualified workers in a field experiencing a provider shortage. Finally, the average hours per case modestly increased over the same period due to the higher acuity needs of individuals receiving services in the program.
“The growth in IHSS expenditures over the last several years reflects intentional policy choices to expand access to IHSS,” Sadwith added. “It is the direct and foreseeable result of expanding eligibility, increasing hourly reimbursement rates, increasing utilization consistent with demographic change, and substituting home-based care for institutional placement—outcomes that CMS has repeatedly endorsed and promoted through federal approvals of California’s IHSS and HCBS programs because they deliver care at a fraction of institutional costs.”
Despite these longstanding federal policy goals and federal approvals for IHSS program growth, CMS’ deferral notice states that CMS is deferring these funds simply because the growth rate in California’s IHSS program is greater than other states.
In addition, CMS’ letter cites program-integrity concerns, but provides no specifics as to what these concerns are other than “statistical outliers.” Program integrity is a core Medi-Cal function focused on ensuring public dollars are spent the right way through extensive oversight, fraud prevention, and enforcement efforts. California maintains strong, longstanding IHSS oversight systems, including annual assessments, electronic timesheets, verification tools, and coordinated state-county review processes.
“IHSS caregivers help people get out of bed, prepare meals, bathe safely, and remain in their homes with dignity. We are grateful for the work they do every day,” Sadwith added. “CMS’ decision recklessly disregards the people who depend on IHSS and the individuals who care for them every day.”
In addition to the IHSS-related deferral, CMS also included roughly $200 million associated with long-standing administrative and technical claiming items that the state has already been working through with CMS. These items are expected, unrelated to IHSS services or caregiver payments, and part of ongoing federal review processes. DHCS voluntarily implemented a 15 percent reduction in administrative claims beginning in early 2025 as part of a comprehensive review to ensure federal funds are not used for state-only programs. These administrative claims are related to program administration and agency operation costs, not health care. DHCS has submitted comprehensive documentation to CMS demonstrating compliance with claiming processes and updated our reduction to account for this review. DHCS continues to work with CMS to provide support for these updated adjustments.
California calls on CMS to immediately restore IHSS funds and will take every step necessary to protect IHSS members and the caregivers who support them.
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