Medi-Cal Voices and Vision Council Meeting Minutes
Date: Wednesday, March 18, 2026
Time: 5:30 - 7:30 p.m.
Type of Meeting: Virtual
(Open to the Public)
Members Present: Ann Marie Torres-Delgadillo; Jenny McLelland; Christian Espinoza; Abigail Coursolle; Mike Odeh; Tiffany Huyenh-Cho; Uchey Dijeh, MD; Azalia Ryckman; Kate Ross; Lucy Marrero; Elissa Feld; Avita Singh; Sydney Turner
Members Not Attending: Linnea Koopmans; Mary Omoto; Lupe Wilson
DHCS Staff: Michelle Baass, Director; Tracy Arnold, Assistant Director; Tyler Sadwith, State Medicaid Director and Chief Deputy Director for Health Care Programs; Yingjia Huang, Deputy Director, Health Care Benefits and Eligibility; Michael Freeman, Assistant Deputy Director, Health Care Benefits and Eligibility; Krissi Khokhobashvili, Deputy Director, Office of Communications; Pamela Riley, Assistant Deputy Director and Chief Health Equity Officer, Quality and Population Health Management; Brian Hansen, Health Program Specialist; Hatzune Aguilar, Stakeholder and Community Engagement Manager, Office of Communications; Eduardo Lozano, Stakeholder and Community Engagement Analyst, Office of Communications; Maria Romero-Mora, Stakeholder and Community Engagement Analyst, Office of Communications; Kiran Poonia, Stakeholder and Community Engagement Analyst, Office of Communications
Additional Information: Please refer to the PowerPoint presentation used during the meeting for additional context and details.
Agenda:
Time
| Content
|
5:30 - 5:50
| Welcome and Opening
|
5:50 - 6:10
| Communications Plan for Work and Community Engagement Requirements
|
6:10 - 7:00
| Small Group Activity and Discussion
|
7:00 - 7:15
| Open Discussion
|
7:15 - 7:25
| Public Comment
|
7:25 - 7:30
| Closing Remarks
|
Welcome and Opening
Type of Action: Information
Presenter: Michelle Baass
Discussion Topics:
Director Michelle Baass welcomed Voices and Vision Council members and members of the public to the meeting. Key points included:
Appreciation for members’ time and participation, and acknowledgement that this was the first public Voices and Vision Council meeting.
A reminder that the council was created to work alongside the Medi-Cal Member Advisory Committee (MMAC) and serves as a space for members, health plans, providers, community‑based organizations, and state and county partners to provide direct input to DHCS leadership.
Lucy Marrero was elected council chairperson following the December election process. However, this would be her final meeting due to a new opportunity. DHCS thanked Lucy for her willingness to serve and acknowledged her contributions to the council.
A reminder that the chairperson election will take place at the June meeting, and that any interested members should notify DHCS.
A brief overview of the meeting’s purpose, including continuing discussions related to the work and community engagement requirements and the opportunity for members to provide feedback.
DHCS provided an overview of the meeting agenda and reviewed the language justice and community norms to remind participants of engagement and participation practices.
Participants were asked to disclose any conflicts of interest; none were identified.
DHCS reviewed the recommendations process, noting that the Voices and Vision Council and the MMAC will follow a multi-meeting approach for developing, reviewing, and voting on recommendations. Approved recommendations will be posted publicly along with DHCS responses and will be included in the federally required annual report.
Communications Plan for Work and Community Engagement Requirements
Type of Action: Information
Presenter: Krissi Khokhobashvili and Yingjia Huang
Discussion Topics:
DHCS provided a refresher on the upcoming work and community engagement requirements and outlined the overall communications approach, with a focus on early, simple, and repeated messaging to help members understand upcoming changes.
Key points included:
DHCS is developing a member‑focused communication strategy using plain language and multiple channels, such as mail, text messages, and outreach through trusted partners.
A phased rollout is planned so messaging begins well before members must take any action, with materials designed to reduce confusion and ensure consistency across counties, health plans, providers, and community organizations.
Initial insights from the early texting campaign were shared, noting strong member engagement and higher link‑click rates in non‑English Medi-Cal threshold languages.
DHCS is preparing a comprehensive communications toolkit that will include flyers, FAQs, and digital assets intended for broad use across the statewide network.
DHCS highlighted the importance of accessibility, including multilingual materials, visual supports, and low‑literacy formats to ensure members understand what is coming and what steps they may need to take.
MMAC Meeting Recap
A member who serves on both the MMAC and Voices and Vision Council provided this recap, summarizing discussions from the March MMAC meeting, where members learned of and discussed the communications plan for the work and community engagement requirements.
Overall, members responded positively to the presentation and appreciated that DHCS is prioritizing early outreach.
Key concerns and needs:
Members highlighted the need for diverse communication channels. One member pointed out continued postal service delays and stressed that mailed notices should always be supported by other forms of outreach.
Several members expressed confusion about where to go for help when they have questions about their Medi‑Cal coverage and the upcoming change, noting that it isn't always clear whether they should contact Medi‑Cal, Supplemental Security Income (SSI), or In-Home Supportive Services (IHSS), and this uncertainty often results in them being redirected between these entities without getting clear answers.
Members requested clearer, step‑by‑step instructions for required forms, suggesting DHCS model guidance after user‑friendly examples, such as Department of Motor Vehicle resources.
Members asked how DHCS plans to ensure all Medi‑Cal members understand the new requirements and how they apply to them. They said the information can be confusing and asked for clear communication so members know exactly what is expected of them.
There was a strong interest in involving schools and universities as trusted messengers.
Preferred ways to receive information:
Members expressed information fatigue and said they often feel overwhelmed by the volume of information they receive. Because of this, they want communication that is trustworthy, easy to verify, and tailored to their specific situation.
Members said texts can be helpful, but only when they are clear, concise, and contain a direct call to action. They also want consistency in how texts are used and the ability to opt in, so messages don't feel unexpected or suspicious.
Some members feel email or traditional mail is more trustworthy.
Members want control over how they receive information (email, text, mail) because different people trust different formats, and one size does not fit all.
Members suggested using visual cues like emojis for urgent reminders, placing flyers in community spaces where members already spend time, and exploring notifications through health plan mobile apps to reach people where they already look for health‑related updates.
Across all methods, members agreed they need information as early as possible so they have enough time to act and avoid coverage/service interruptions.
Most trusted messengers:
Schools (K–12 and colleges/universities)
Health care providers (doctors, dental, vision care offices)
Community clinics, consumer advocacy groups, and Legal Aid
Pharmacies and Medi‑Cal Rx‑based locations
Enhanced Care Management (ECM) managers and county workers, who often have established relationships with members
Local resource centers frequently used by the community
Small Group Activity and Discussion
Type of Action: Information
Presenter: Maria Romero-Mora and Kiran Poonia
Discussion Topics:
Members were divided into two groups, Group A and Group B. Group A began with a facilitated verbal discussion, while Group B took part in an interactive activity on a Miro Board. Halfway through this section, groups switched so all members could participate in both activities. The feedback from both groups is organized below.
Miro Board Feedback
Phase 1: Awareness and Preparation (January 1, 2026 through Mid 2026)
Deliverable: Send targeted text messages to Medi-Cal members to inform them about upcoming eligibility changes under H.R. 1, including the work and community engagement requirements.
Proposed timing is reasonable, but early text messages may raise questions that cannot yet be answered, including how to report compliance, how exemptions work, or whether the rules apply to an individual.
Text messages must include clear, verifiable links, as many people distrust unfamiliar texts due to scams.
Some community health workers (CHW) have had to address confusion caused by unclear text communications.
Digital and communication barriers, such as frequent phone loss, number changes, and service interruption, reduce the effectiveness of large-scale texting and increase “Unable to Contact” outcomes.
More evaluation is needed to understand how often text messages successfully reach Medi-Cal members and how likely members are to act based on receiving a text.
Deliverable: Share H.R. 1 updates, such as the work and community engagement rules, at DHCS stakeholder meetings, public forums, workgroups, advisory committees, etc.
If needed, this deliverable may be addressed later in the timeline.
Early updates are appreciated, and continued communication through 2026–2027 will be important as guidance evolves.
Information should be shared repeatedly, especially in trusted community settings, to reach students, undocumented communities, and others who need multiple opportunities to understand the changes.
Deliverable: Meet with implementation partners (counties, MCPs, eligibility systems, members, community partners, advocates, health care providers, CoveredCA) to solicit input on ways to implement and provide effective outreach for, new work reporting requirements and implications.
Clarification is needed on whether this engagement has already begun.
Messaging must be aligned before any outreach occurs to prevent conflicting information from reaching members.
Inclusion of Medi-Cal managed care plans (MCP) is essential, given their experience with outreach and member communication.
Engagement with partners should continue through 2027.
Deliverable: Create partner toolkits that include downloadable and personalized outreach materials, such as flyers, FAQs, and social media posts.
Consistent statewide and local messaging is essential, and DHCS’ leadership in this area is appreciated.
MCPs can help test messaging, like the effective collaboration used during the COVID-19 public health emergency (PHE) unwind.
There may not be enough information yet to create accurate toolkits; this work may need to occur later in the timeline.
Toolkits should include step-by-step visuals and short instructional videos to simplify complex information.
Deliverable: Update the DHCS website educating members about the work and community engagement rules.
Website updates should occur before text messages are sent, so people can immediately verify information.
A phased approach is recommended, starting with general awareness and expanding to detailed instructions as guidance becomes available.
Ongoing updates through 2027 will be necessary, as the rules and processes will continue to evolve.
The tone and structure of the current “don’t panic” message and webpage are well-received.
Phase 2: Support and Action (Mid 2026 through January 1, 2027)
Deliverable: Equip clinic-based navigators and local partners with outreach tools and guidance so they can effectively educate members on the steps needed to maintain Medi-Cal coverage.
This support is needed as soon as possible.
Trainings should accompany these tools.
This deliverable is viewed as essential, as clinic and community partners are primary points of support for members.
Deliverable: Continue the text messaging campaign that began in Phase 1.
Text messages work best when paired with mailed notices and personalized information, such as renewal dates and instructions.
Clinics need time and support to distribute materials; not all clinics have the capacity to post or share them consistently.
Deliverable: Engage in multi-channel communications (mail, text, web, print, social) explaining: who the work reporting requirement applied to, who is exempt, and what activities count towards compliance.
Earlier implementation is preferred.
Communication should continue through 2027.
Broad terms like “work requirements” or “six-month renewals” often lead people to believe the rules apply universally; clear targeting is needed, ideally beginning by Q2 2026.
Confusion about who belongs to the New Adult group is widespread; communications should be tailored to specific groups to avoid misunderstandings.
Word of mouth plays a strong role in how information spreads; consistent messaging across all channels is essential.
Multi-channel outreach is necessary due to mail delays and information overload.
Deliverable: Toolkits for county enrollment offices, health plans, partners (messaging guides, flyers, FAQs) posted on the DHCS website in all 19 threshold languages.
Earlier release is strongly recommended.
Materials should be culturally responsive and available in all threshold languages.
Toolkits should direct people to trusted local sources for assistance and ideally be tailored to county or regional contexts.
Releasing materials in early Q3 would give MCPs at least four weeks to integrate messaging into provider communications.
A minimum 2–3-month runway is needed for dissemination and training.
Deliverable: Provide training on H.R. 1 provisions, along with clear policy guidance, practical tools, and ongoing technical assistance, so partners (including plans, county workers, navigators, CHWs, and coverage ambassadors) can confidently support member and prevent errors on member cases.
Training should begin in Phase 1 so staff are prepared for member questions.
2 to 3 months of preparation time is needed due to the scale and complexity of H.R. 1 changes.
Communication challenges stem partly from system coordination issues; members often do not know who to contact.
Training and technical assistance should continue in 2027.
Gaps and Improvements
BenefitsCal could be used to display individualized prompts indicating whether work requirements apply or whether documents are needed.
Additional portal information is needed to help members understand their aid codes and eligibility categories.
Text messaging effectiveness should be reassessed often, given the digital and phone access challenges.
Collaboration with agencies, such as the Department of Developmental Services (DDS) and Employment Development Department (EDD) could help broaden communication.
A clear statement is needed that Dual Eligible Special Needs Plans (DSNP) members are not subject to work requirements.
More clarity is needed on the role of CHWs and if they are integrated into the communications strategy.
Member-specific information is important, including: Am I affected? What does this mean? What do I need to do?
Information should also flow through the California Department of Social Services (DSS), California Department of Education (CDE), California Department of Corrections and Rehabilitation (CDCR), and other state-level channels.
Special outreach is needed for Home and Community-Based Alternatives (HCBA) waiver agencies; although waiver participants are exempt, counties may not always code aid correctly.
Early and comprehensive information will reduce confusion.
MCPs should be involved earlier in message development and given access to draft materials to support alignment.
Earlier release of finalized materials would strengthen Phase 1 readiness.
MCPs could be used as communication and validation channels to ensure message consistency statewide.
Working Together
DisCo (California Disability Community Advocacy) at the Capitol offers opportunities to reach key communities.
Legal advocates can help distribute information through trusted networks.
Enrolling family caregivers as IHSS workers could help ensure caregiving hours count toward engagement requirements.
Workforce development boards, Goodwill, and similar organizations can support employment and training pathways.
CHWs, Promotores, and representatives are eager to participate and stay informed.
State universities and community colleges may be able to share enrollment data to support automatic credit for qualifying activities.
MCPs can reinforce aligned messaging through providers and community channels, but timely release of materials is essential for consistent outreach and to prevent misinformation.
Verbal Feedback
During the verbal discussion, members were invited to reflect on the outreach planning and provide feedback using four guiding questions:
After hearing the initial planning for outreach, what are your initial reactions? Are there additional ideas we should consider as we develop the plan to support Medi-Cal members?
In your experience, what is the best way to notify Medi-Cal members of changes to their coverage?
What is your organization planning to do for outreach?
Given that we all represent different points of contact in the Medi-Cal system, how can we work together to communicate these changes effectively?
The feedback is as follows:
Initial reactions to the outrech plan and additional ideas
The overall communications plan was viewed as thoughtful and well-developed, with appreciation for DHCS’ early planning.
There is a tension between providing early information and avoiding unnecessary alarm when state and federal guidance is still shifting.
Determining whether the work requirements apply is difficult because many people do not know their eligibility category (full-scope, managed care, exemptions, etc.). There is interest in a simple tool or indicator, such as an aid‑code explanation or a “Does this apply to me?” prompt, to help members understand their status.
BenefitsCal could be enhanced to show personalized information, since members already use it to view renewal dates and case updates. Adding clear links or banners about renewal frequency and 2027 changes would make the website more useful.
There is strong desire for more details on exemptions, including how medical frailty will be determined. Earlier information would help people make decisions (e.g., enrolling in school or finding volunteer opportunities).
More clarity is needed around transitions between Medi-Cal, SSI, and Covered California. People transitioned to Covered California sometimes receive unexpected bills. Having Covered California represented in future meetings would help address these issues.
Continued outreach beyond January 2027 is encouraged, especially as members will still need support during renewals and implementation.
Best ways to notify Medi-Cal members of changes
No single communication method works for all members. Some people respond to texts; others act only after receiving mailed notices. A layered, multi-channel approach is necessary.
Trusted messengers, such as community-based organizations (CBO), CHWs, and local clinics, are essential. These partners often understand their communities in ways large systems cannot (e.g., who has internet access, who prefers paper, who needs in‑person support).
Communication must account for low health literacy in many communities, sometimes at a kindergarten reading level, and for individuals who speak English as a third or fourth language. Messaging should be simple, visual, and easy to understand.
Text messaging has limitations due to frequent phone loss, number changes, and service interruptions; text outreach must be supported by mail, in-person support, and follow-up channels.
Other community access points (CalFresh offices, grassroots nonprofits, and similar agencies) should also be used to reach members.
Clinical settings (primary care, urgent care, emergency rooms (ER), federally qualified health centers (FQHC)) are especially important because people often learn about coverage issues at the point of care.
Outreach activities organizations are planning or considering
MCPs are already sharing information about upcoming eligibility changes in Community Advisory Committees and want to coordinate their efforts with DHCS.
MCPs requested finalized toolkits by early Q3, allowing time for printing, provider distribution, and internal training. Many provider-facing materials require advance planning.
Repeated exposure to materials increases staff comfort; some organizations must see toolkits multiple times before fully integrating them.
CHWs and CBOs conducting daily outreach need clear, consistent information to help members navigate Medi-Cal, SSI, and Covered California.
Some clinics cannot assist with Medi-Cal issues without additional resources; support or incentives for provider staff could improve member assistance.
Several organizations are already conducting outreach, education, and renewal support, but need clearer guidance on exemptions, workforce reporting, and transitions.
How partners across the Medi-Cal system can work together
System alignment is needed so members know where to go for help (Medi-Cal, SSI, Covered California, CHWs, navigators, or their provider).
Regional, repeated trainings would build a consistent understanding across providers, MCPs, county workers, CHWs, and navigators.
Faster DHCS approval for low‑risk edits (e.g., co‑branding) would prevent long delays in provider communications.
Strengthening provider communication is essential, as inconsistent or incorrect information from clinics can undermine outreach.
Partnerships with ERs, urgent care centers, high-volume Medi-Cal clinics, and FQHCs would reduce missed opportunities to assist members presenting with inactive coverage.
Collaboration with CalFresh offices, workforce development boards, Goodwill, community colleges, and state schools would expand outreach.
Supporting clinics with staff resources or incentives would enhance their ability to help members at the point of care.
MCPs and community partners are ready to collaborate on message development, training, and distribution if materials and drafts are shared early enough to prepare.
Open Discussion
Type of Action: Information
Facilitators: Eduardo Lozano and Hatzune Aguilar
Discussion Topics:
DHCS provided a report-out from both Groups A and B, highlighting shared themes, such as the need for early coordination, clearer guidance on eligibility and exemptions, consistent messaging across partners, simple and culturally appropriate materials, and the importance of trusted messengers and multiple outreach channels.
Public Comment
Type of Action: Public Comment
Discussion Topics:
Carol Brown, a consultant and public health nurse with Alameda County Children and Family Services, and co‑chair of Accessing Health Care for California’s Children in Foster Care with Children Now, emphasized the importance of supporting former foster youth. She noted that former foster youth are exempt, which she was glad to see, but explained that many do not know they have Medi‑Cal coverage until age 26 or that they are exempt from work requirements. Brown shared that because CalSAWS (California Statewide Automated Welfare System) does not always communicate effectively with Medi-Cal Eligibility Data System (MEDS), former foster youth can temporarily lose their eligibility without realizing it until they go to the pharmacy. She added that many youth then go to social services to apply for Medi‑Cal, and it is important for staff to recognize when someone is a former foster youth and refer them to foster care eligibility contacts, as had been done in the past. She also explained that many foster youth do not know about the MC 258 form, a simple one‑page application created by the state and advocates for youth who permanently change counties. The form only requires a name and updated address, and submitting it ensures that Medi‑Cal can be reinstated or transferred correctly. Brown concluded by reaffirming her appreciation that former foster youth are exempt, while emphasizing the need for more education on this topic. She also noted her assumption that relative caregivers are exempt because of their role.
Susan LaPadula, from the Inter County Medical Reimbursement Specialists (ICMRS), thanked DHCS and commented on the summaries provided earlier regarding providers, MCPs, counties, and CDSS, emphasizing the importance of all these entities having information in real time. She shared a suggestion learned from another part of the Department: establishing a LISTSERV so everyone who needs up‑to‑date information, including providers, MCPs, county partners, and CBOs, can receive updates directly from DHCS as they are released. LaPadula noted that she has raised this suggestion with DHCS leadership in the past and hopes it will be considered.
Upcoming Meeting and Next Steps
Type of Action: Information
Facilitators: Kiran Poonia
Discussion Topics:
Next MMAC Meeting:
Date: Wednesday, June 3, 2026
Time: 5:30 - 7:30 p.m.
Format: Virtual, closed to the public
Next Voices and Vision Council Meeting:
Date: Wednesday, June 17, 2026
Time: 5:30 - 7:30 p.m.
Format: Virtual, open to the public, and includes public comment
All meeting materials and resources are available on the DHCS website.
Members interested in running for chairperson should contact DHCS. Interested candidates will be invited to briefly share a vision statement during the June meeting; after the meeting, members will cast their vote confidentially and anonymously, consistent with the prior process.
Closing Remarks
Type of Actions: Information
Presenter: Michelle Baass, Director
Discussion Topics:
Adjournment of Meeting
Name of person who adjourned the meeting: Michelle Baass
Time Adjourned: 7:30 p.m. PST
