ਤਾਰੀਖ: ਜੂਨ 23, 2026

ਸਮਾਂ: ਸ਼ਾਮ 5:30 ਵਜੇ - ਸ਼ਾਮ 7:30 ਵਜੇ

Type of Meeting: Virtual (Open to the Public)

Public Attendees: 71

Members Present: Ann Marie Torres-Delgadillo; Jenny McLelland; Christian Espinoza; Mike Odeh; Uchey Dijeh, MD; Azalia Ryckman; Kate Ross; Elissa Feld; Sydney Turner; Linnea Koopmans; Marty Omoto

Members Not Present: Abigail Coursolle; Avita Singh; Lupe Wilson; Tiffany Huyenh-Cho; Marlen Torres

DHCS Staff and Partners: Michelle Baass, Director; Tracy Arnold, Assistant Director; Krissi Khokhobashvili, Deputy Director, Office of Communications; Yingjia Huang, Deputy Director, Health Care Benefits and Eligibility; Tyra Taylor, Assistant Deputy Director, Program Operations; Michelle Retke, Chief, Managed Care Operations; Brian Hansen, Policy Advisor to the Directorate; Michael Freeman, Assistant Deputy Director, Health Care Benefits and Eligibility; Joseph Billingsley, Assistant Deputy Director, Integrated Systems of Care, Health Care Delivery Systems; Pamela Riley, Chief Health Equity Officer; Hatzune Aguilar, Stakeholder and Community Engagement Manager; Eduardo Lozano, Stakeholder and Community Engagement Analyst; Maria Romero-Mora, Stakeholder and Community Engagement Analyst; Kiran Poonia, Stakeholder and Community Engagement Analyst; Isabel Flores, Stakeholder and Community Engagement Analyst; Evelyne Kane, Associate Director of Community Engagement and Capacity Building, Camden Coalition; Marisol Caban, Associate Director of Community Engagement and Capacity Building, Camden Coalition; India Hayes Larrier, Senior State Advocacy Manager, Community Catalyst

ਵਾਧੂ ਜਾਣਕਾਰੀ: ਕਿਰਪਾ ਕਰਕੇ ਵਾਧੂ ਸੰਦਰਭ ਅਤੇ ਵੇਰਵਿਆਂ ਲਈ ਮੀਟਿੰਗ ਦੌਰਾਨ ਵਰਤੀ ਗਈ ਪਾਵਰਪੁਆਇੰਟ ਪੇਸ਼ਕਾਰੀ ਵੇਖੋ।

Agenda:

ਸਮਾਂ	ਸਮੱਗਰੀ
5:30 – 5:50	ਸਵਾਗਤ ਅਤੇ ਜਾਣ-ਪਛਾਣ
5:50 – 5:55	Recommendations Voting Process
5:55 – 6:05	ਚੇਅਰਪਰਸਨ ਦਿਲਚਸਪੀ ਬਿਆਨ
6:05 – 6:30	DHCS Presentation: Transition of Unsatisfactory Immigration Status Medi-Cal Members to Fee-for-Service
6:30 – 7:20	ਸਮੂਹ ਚਰਚਾ ਅਤੇ ਮੈਂਬਰਾਂ ਦੀਆਂ ਟਿੱਪਣੀਆਂ
7:20 – 7:25	ਜਨਤਕ ਟਿੱਪਣੀ
7:25 – 7:30	ਸਮਾਪਤੀ ਟਿੱਪਣੀਆਂ ਅਤੇ ਅਗਲੇ ਕਦਮ

ਸਵਾਗਤ ਅਤੇ ਜਾਣ-ਪਛਾਣ

ਕਾਰਵਾਈ ਦੀ ਕਿਸਮ: ਜਾਣਕਾਰੀ

Presenters: Michelle Baass

Opening Items:

• Voices and Vision Council members were welcomed, and the language justice and community norms were reviewed to remind participants of engagement and participation practices.
• ਭਾਗੀਦਾਰਾਂ ਨੂੰ ਹਿੱਤਾਂ ਦੇ ਕਿਸੇ ਵੀ ਟਕਰਾਅ ਦਾ ਖੁਲਾਸਾ ਕਰਨ ਲਈ ਕਿਹਾ ਗਿਆ ਸੀ; ਕਿਸੇ ਦੀ ਵੀ ਪਛਾਣ ਨਹੀਂ ਕੀਤੀ ਗਈ।
• DHCS welcomed a new member to the Voices and Vision Council and invited all DHCS and Voices and Vision Council members to introduce themselves.

Recommendations Voting Process

ਕਾਰਵਾਈ ਦੀ ਕਿਸਮ: ਜਾਣਕਾਰੀ

Presenters: Kiran Poonia

Process Overview:

• DHCS started a new collaborative process for developing recommendations from the Medi-Cal Member Advisory Committee (MMAC) and the Voices and Vision Council.
• DHCS has completed its first full topic cycle focused on the work and community engagement rule, which was discussed during both the December and March Voices and Vision Council meetings.
• The recommendations reflect the collective priorities of the group, not just any one person’s comments.
• Following the meeting, Voices and Vision Council members will receive an email with instructions for voting on the first set of recommendations.
• DHCS will post the recommendations publicly and track progress and updates as they become available.

ਚੇਅਰਪਰਸਨ ਦਿਲਚਸਪੀ ਬਿਆਨ

ਕਾਰਵਾਈ ਦੀ ਕਿਸਮ: ਜਾਣਕਾਰੀ

Presenters: Kiran Poonia

Chairperson Statements:

• Christian Espinoza and Sydney Turner shared brief statements indicating their interest in serving as Chairperson for the Voices and Vision Council.
• Following the meeting, members received an email with instructions on how to cast their vote. Voting was conducted confidentially and online.

DHCS Presentation: Transition of Unsatisfactory Immigration Status Medi-Cal Members to Fee-for-Service

ਕਾਰਵਾਈ ਦੀ ਕਿਸਮ: ਜਾਣਕਾਰੀ

Presenter: Yingjia Huang

Presentation Details:

• DHCS discussed the upcoming transition of unsatisfactory immigration status (UIS) Medi-Cal members from managed care into fee-for-service (FFS).
• ਮੁੱਖ ਨੁਕਤੇ ਸ਼ਾਮਲ ਹਨ:
  • On January 1, 2027, Medi-Cal members with UIS will transition from Medi-Cal managed care to FFS.
  • This change is required by new federal guidance issued by the Centers for Medicare and Medicaid Services, and is outlined in the State Medicaid Director Letter.
  • Medi-Cal members with UIS include: 
    • All undocumented immigrants (including children and pregnant people).
    • Lawful permanent residents (Green Card holders) who have been in the U.S. for less than five years.
    • Permanently Residing Under Color of Law (PRUCOL), non-citizens living in the U.S. with the knowledge and permission of immigrations authorities (such as those with pending asylum or stay of deportation) while they wait for a final status.
  • Populations not affected include: 
    • ਅਮਰੀਕੀ ਨਾਗਰਿਕ 
    • Lawful permanent residents (Green Card holders) who have been in the U.S. for five years or longer.
  • Under FFS Medi-Cal:
    • Benefits are not coordinated by a Medi-Cal health plan; there is no assigned care team or “medical home.”
    • Members will need to find and verify Medi-Cal providers who are currently accepting new patients.
    • Members will need to take with them their Medi-Cal Beneficiary Identification Card, also known as their “BIC.”
    • Members will lose access to some services and benefits, including Community Supports and Enhanced Care Management, which are only available through managed care. 
  • Impacted members will automatically transition to FFS Medi-Cal  starting January 1, 2027.
  • DHCS is committed to working closely with Medi-Cal members, managed care plans, providers, and community partners to support members throughout the transition. 
  • DHCS will help members understand what this change means for their care by ensuring they know how to:
    • Continue getting services.
    • Find FFS providers.

Recap of June 3 MMAC Meeting

• A member who serves on both the MMAC and Voices and Vision Council provided this recap, summarizing discussions from the June MMAC meeting, where members learned of the upcoming transition of UIS Medi-Cal members to FFS.
• Key concern:
  • MMAC members expressed concerns about how this change will be perceived by immigrant communities in the context of many other challenges (e.g., federal immigration enforcement), creating confusion, instability, and harm for already vulnerable communities.
  • MMAC members expressed concerns about barriers to accessing care and identifying providers that accept FFS, especially in rural and high-risk areas where providers are already lacking. 
  • Some questions and concerns were raised about costs associated with FFS and how these fees could further limit or discourage people from seeking or obtaining care.
  • A strong sentiment was expressed that everyone, including immigrants, should be able to get health care, and that taking away care is unfair and harmful. 
  • MMAC members spoke about concerns of how these changes could lead to wider impacts on the health care system, potentially affecting specialty care, community clinics, and other services. 
• Key suggestions for actions DHCS can take to support members affected by the transition:
  • Train trusted community messengers, such as peer support specialists, community health workers, promotoras, and ambassadors, about the transition and how to support impacted individuals through one-on-one engagement.
  • Ensure lists of providers who accept FFS Medi-Cal are up to date and easily accessible to affected members.
  • Explain and clarify the term “fee-for-service” in communication materials, as it can be misleading because it sounds like members must pay for each health care service they receive.
  • DHCS should collect data (e.g., claims data, emergency department visits, etc.) and engage directly with affected Medi-Cal members (e.g., focus groups, feedback surveys) during and after the transition to understand the real-world impacts, challenges, and opportunities to enhance support.
  • Provide additional support and information for those who will need to change Durable Medical Equipment providers as a result of switching into FFS, as these transitions can be more difficult and complicated than changing providers.
  • Utilize trauma-informed approaches to communication and support services in acknowledgement of the fear, distrust, and challenges being experienced by immigrant communities.

ਸਮੂਹ ਚਰਚਾ

Type of Action: Discussion

Member Feedback:

What is your immediate reaction? (Verbal)

• Members expressed concerns about how this change will impact continuity and transitions of care, specifically for individuals with pre-scheduled medical procedures that will occur after the change in coverage, individuals who are receiving Enhanced Care Management (ECM), and individuals with complex medical needs.
• There were concerns about the challenges members may experience in identifying providers who accept FFS Medi-Cal, noting both challenges related to limited provider networks as well as how new members in managed care plans will likely have limited prior experience in identifying new providers (as managed care plans typically provide support/tools for this process).
• Members noted potential confusion and unfamiliarity with the term “fee-for-service” and how this could be misunderstood as denoting a fee for members to receive health care services.
• Members voiced significant concern about the adequacy of the FFS network and access barriers, and suggested that DHCS map existing provider networks to identify geographic/regional gaps and invest in creating a navigation tool to help members identify new providers.
• One member noted how the term “unsatisfactory immigration status” could lead to concerns about immigration enforcement that could deter individuals from seeking care.

When people first hear about the transition of UIS Medi-Cal members to FFS, what do you think will need to be explained first? (Mentimeter, ranking)

• Through the ranking exercise, Voices and Vision Council members indicated that communication should prioritize information about who will be affected, where members can go for help, and when the change will happen. Members ranked the topics in the following order:
  • Who will be affected.
  • Where members can go for help.
  • When the change will happen.
  • What members need to do.
  • How this may affect care.
  • Why this change is happening.

Looking at these responses, why do you think these points need to be explained first? (Verbal)

• Members shared that they are already asking if the transition applies to them and expressed concern about how the change may affect their health coverage.
• Emphasized that members need clear information about where to go for help, particularly if they need to change providers or are receiving ongoing treatment.
• Noted that communications should reassure members that they are not losing Medi-Cal coverage and clearly distinguish between a change in delivery system from a loss of benefits.
• Members recommended explaining the term “fee-for-service” in plain language to prevent members from believing they will be required to pay for medical care.
• Cautioned that explaining the reasons behind the policy change should not be prioritized in initial communications, noting that doing so may create additional confusion. However, another member noted that some people want to understand why a change is being made to their coverage.
• Discussed the importance of using language that is sensitive to concerns related to immigration status and avoids creating unnecessary fear or uncertainty.
• Suggested that communications recognize that members have different information needs by providing simple, high-level information initially, with opportunities to access more detailed information if desired.
• Members noted that multiple Medi-Cal and budget-related policy changes occurring simultaneously may increase confusion for members and recommended coordinating messaging across related communications whenever possible.

What resources do you know of that Medi-Cal members are using to find FFS providers? (Mentimeter, open-ended)

• Word of mouth, family members, friends, trusted providers, community health workers (CHW), promotores, federally qualified health centers (FQHC), and community clinics as the primary resources Medi-Cal members currently use to find providers.
• Shared that many Medi-Cal members rely on trusted messengers to explain available resources and help them navigate provider options rather than locating information independently online.
• Existing DHCS websites and provider search tools can be difficult to locate and navigate and recommended making provider search resources more prominent and easier to access. The current provider search application may be difficult for Medi-Cal members to use, including challenges searching by provider type and locating appropriate providers.
• Members recommended improving the usability of online provider search tools and increasing awareness of existing digital resources, including the DHCS mobile application.
• Printed materials, including flyers and other easy-to-share resources, remain important for members who have limited internet access or prefer receiving information in paper format.
• Trust is a significant factor in whether members use available resources. Members are more likely to rely on information provided by their doctor, CHW, or another trusted messenger than information found independently online.
• Recommended providing trusted messengers with clear, easy-to-understand educational materials so they can consistently assist Medi-Cal members during the transition.
• Members expressed concern that many Medi-Cal members currently receive assistance locating providers through their managed care plans and emphasized that members transitioning to FFS may need additional navigation support to assume this responsibility independently.

What other challenges do you anticipate Medi-Cal members running into as they try to find a FFS provider? (Verbal)

• Language barriers, limited digital literacy, transportation challenges, and limited familiarity with online provider search tools may make it more difficult for some members to locate participating providers.
• Members recommended providing printable materials, step-by-step guidance, and multiple navigation options to support members with different communication preferences and levels of technology access.
• Suggested creating a mechanism for Medi-Cal members to provide feedback about their experiences locating FFS providers, including challenges encountered and resources that were helpful, to support ongoing improvements.

ਜਨਤਕ ਟਿੱਪਣੀਆਂ

ਕਾਰਵਾਈ ਦੀ ਕਿਸਮ: ਜਨਤਕ ਟਿੱਪਣੀ

Comments from Public Attendees:

• Damone Thomas with the Healing with Hope Corporation and the California Planning Group cautioned that major policy changes often generate fear that distorts how information is shared and understood. He described past experiences in which emotional reactions led to misinformation in the community, offering an example from federal student loan changes in which early messaging caused confusion until he researched the details himself. Thomas urged DHCS to provide clear, direct communication to prevent unnecessary panic and emphasized that benefits counselors will be essential for helping members navigate and maintain care under new rules.

• Van Do-Reynoso, MPH, PhD, Chief Customer Experience and Chief Health Equity Officer at CenCal Health, read and shared a written public comment submitted by Medi-Cal members who could not attend. Member comments are included below:
  • Claudia Caceres, founder and executive director of Tu Tiempo Digital Contigo, described her 15 years serving Latino and Indigenous communities in Santa Barbara and San Luis Obispo counties, particularly in Santa Maria, where approximately 80% of residents are Latino and Indigenous (including communities from Guerrero, Oaxaca, and Michoacán). Caceres expressed strong concern that transitioning Medi-Cal members with unsatisfactory immigration status to FFS would deny access to vital physical, mental, and dental health services. She characterized the proposal as discriminatory toward immigrant communities, noting that many families already struggle with rising costs and often must choose between food and medical care. Caceres emphasized that Medi-Cal deductions come directly from workers’ paychecks, yet those same individuals now face losing coverage despite health care being a right, regardless of immigration status. She urged DHCS to reject the proposal and adopt the alternative coordinated-care approach supported by physicians, hospitals, counties, behavioral health providers, and health plans to ensure comprehensive and accessible Medi-Cal coverage for all populations.Alma Valle, speaking on behalf of her daughter Sarah Navarrete, shared that her daughter, who has anxiety, depression, ADHD, and is awaiting an autism evaluation, recently lost her psychiatrist and now only receives support from a psychologist and therapist. Valle stated this disruption has had a severe impact on their family and expressed deep concern that the proposed transition to FFS would further destabilize access to coordinated behavioral health care. She stressed that while the state must comply with federal guidelines, compliance does not require adopting a harmful policy, and urged DHCS to adopt the alternative coordinated-care proposal supported by health plans, providers, counties, hospitals, and behavioral health organizations to protect comprehensive care for Medi-Cal members with unsatisfactory immigration status.Concepcion Pérez, a 70-year-old resident of Santa Maria, recounted being asked at their dental clinic to sign a form stating their Medi-Cal coverage would end in June and they would be responsible for their dental expenses beginning in July. Pérez explained that they are unemployed and cannot afford ongoing implant and root canal treatments and stated that losing Medi-Cal coverage would significantly affect their health and prevent them from continuing necessary dental care. Pérez respectfully urged the state to reject the proposal, expressing sadness and worry regarding their ability to complete treatment.
  • Norma Alonso, a resident of Santa Maria, expressed that cutting or restructuring Medi-Cal would harm entire communities, especially undocumented individuals with chronic illnesses who cannot afford private insurance. Alonso emphasized that the risk of transferring members with unsatisfactory immigration status from managed care to FFS is too high. She acknowledged the need to comply with federal rules, but stressed that federal requirements do not obligate the state to adopt a policy that undermines access. Alonso urged DHCS to adopt the alternative coordinated-care approach supported by providers, counties, hospitals, behavioral health organizations, and health plans, ensuring comprehensive and coordinated care for all individuals, regardless of immigration status.

• Linsey Rodriguez, health policy advocate for the Mixteco and Indigenous Community Organizing Project (MICOP),urged DHCS to reject the proposal to move Medi-Cal members with UIS out of managed care and into FFS. She explained that the transition would present significant risks to coordinated care and likely cause harm to the affected members. Rodriguez noted that California is attempting to comply with federal guidance; however, compliance does not require adopting a policy that undermines access or continuity of care. Rodriguez encouraged DHCS to adopt the alternative coordinated-care proposal put forward by statewide leaders, including physicians, hospitals, counties, behavioral health providers, and plans, to protect comprehensive care for UIS members. She emphasized the importance of ensuring that all populations, regardless of immigration status, have access to coordinated and accessible medical services.

• Beth Burt,Executive Director of the Autism Society Inland Empire, thanked DHCS for hosting the conversation in a public forum and highlighted how important the information shared during the meeting would be for families served by her organization, many of whom are undocumented. She expressed gratitude to the Voices and Vision Council and DHCS for their work and noted the importance of bringing accurate information back to the communities she supports.

• Dr. Doug Major urged DHCS to ensure that school nurses are included as key resources in any transition planning. Major explained that school nurses are frontline responders for children’s health needs and serve as critical access points for families. He stated that empowering school nurses with clear information about the transition would significantly strengthen support for children. Major also recommended leveraging managed care plans’ quality health equity committees, where he has served for several years, as additional infrastructure for communication and community support. Major noted pressing health needs among Mixteco children, stating that 60–70% require eyeglasses, yet many are not receiving needed vision care. He stressed that vision problems strongly affect school performance and that addressing these needs is essential to breaking cycles of intergenerational academic struggle. Major encouraged DHCS to maintain focus on children’s needs while navigating federal requirements.

• Elizabeth, a resident of Santa Clara County, with DHCS project experience and lived experience navigating multiple systems, voiced appreciation for DHCS’ approach. She commented that while the federal context is difficult, DHCS has designed a “creative compromise” by shifting members to FFS, which still preserves access to care. She expressed relief that she can communicate to her community that Medi-Cal services remain accessible. She suggested that messaging should begin with the reassurance, “You haven’t lost your care, it’s just going to come in a different way.” She noted that federal messaging has often produced panic, and DHCS communications will need to actively reduce that fear and provide pathways for members to understand exemptions and maintain coverage. Elizabeth also explained that, given the broader statewide move toward FFS models, community‑based organizations will need support in learning how to bill for services so they can effectively participate in care delivery. She concluded by stating she learned a great deal from the meeting and appreciated the discussion.

• Yolando Zamora, a care manager from Santa Maria serving San Luis Obispo and Santa Barbara counties, expressed deep concern that the transition from managed care to FFS for Medi-Cal members with UIS would disrupt continuity of care and create additional barriers. Zamora explained that many individuals and families she works with already face significant obstacles, such as language differences, transportation challenges, and difficulties navigating complex health systems. Moving these members into FFS risks adding confusion and making it harder for them to find providers or receive timely services. Zamora acknowledged the need for DHCS to comply with federal guidance, but emphasized that alternative solutions exist, supported by providers, counties, hospitals, behavioral health organizations, and health plans, which would preserve equitable and coordinated access to care.

ਅਗਲੇ ਕਦਮ

ਕਾਰਵਾਈ ਦੀ ਕਿਸਮ: ਜਾਣਕਾਰੀ

Presenter: Kiran Poonia and Michelle Baass

Items Discussed:

• DHCS provided an update about the annual report that is required under the CMS Access Final Rule. DHCS is currently finalizing the draft and will be sharing it with the MMAC and Voices and Vision Council members for review following the meeting.
• The annual report must be finalized by July 9, 2026, and then posted publicly within 30 days, as required by the Final Rule.
• Director Baass thanked members for their engagement and for being part of this space of collaboration with the DHCS team. 
• Members were encouraged to continue to visit the Medi-Cal Changes webpage to find information about the latest updates to the Medi-Cal program and connect to resources for Medi-Cal ambassadors.

Closing Remarks and Meeting Adjournment

ਮੀਟਿੰਗ ਮੁਲਤਵੀ ਕਰਨ ਵਾਲੇ ਵਿਅਕਤੀ ਦਾ ਨਾਮ: ਮਿਸ਼ੇਲ ਬਾਸ

Time Adjourned: 7:30 p.m. PDT