Medi-Cal Children's Health Advisory Panel (MCHAP) Meeting Minutes
Date: Thursday, November 6, 2025
Time: 10 a.m. - 2 p.m.
Type of Meeting: Hybrid
Members Present: 15
Public Attendees: 55
DHCS Staff Presenters: Michelle Baass, Director; Tracy Arnold, Assistant Director; Pamela Riley, MD, MPH, Assistant Deputy Director and Chief Health Equity Officer, Quality and Population Health Management; Linette Scott, MD, MPH, Deputy Director and Chief Data Officer, Enterprise Data and Information Management; Paula Wilhelm, MPP, MPH, Deputy Director, Behavioral Health
External Presenters: Petra Steinbuchel, MD, Director, University of California, San Francisco, Cal-MAP
Additional Information: Please refer to the PowerPoint presentation used during the meeting for additional context and details.
Member Attendance:
Michael Weiss, M.D.; Present; Virtual
Ellen Beck, M.D.; Present; Virtual
Elizabeth Stanley Salazar; Present; Virtual
Diana Vega; Present; Virtual
Nancy Netherland; Present; In Person
Jeff Ribordy, MD, MPH, FAAP; Present; In Person
Karen Lauterbach; Present; Virtual
Kenneth Hempstead, M.D.; Present; In person
William Arroyo, M.D.; Present; Virtual
Ron DiLuigi; Present; Virtual
Lesley Latham, D.D.S., MS; Present; Virtual
Alison Beier; Present; Virtual
Jovan Salama Jacobs, Ed.D; Present; Virtual
Kelly Motadel, M.D.; Present; Virtual
Jan A. Schumann; Present; Virtual
Повестка дня
Время
|
Тема
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10:00 - 10:10
| Добро пожаловать, вступительные комментарии, перекличка и повестка дня
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10:10 - 10:50
| Improving Preventive Care Services through Medi-Cal for Kids and Teens
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10:50 - 11:25
| Drug Medi-Cal and Drug Medi-Cal Organized Delivery System: Penetration Rate Data and Discussion
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11:25 - 12:30
| The California Child and Adolescent Mental Health Access Portal (Cal-MAP)
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12:30 - 12:45
| Membership Renewal and Chairperson Election
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12:45 - 1:15
| Break
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1:15 - 1:40
| Обновление от директора
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1:40 - 1:50
| Публичный комментарий
|
Добро пожаловать и представить
Type of Action: Action
Recommendation: Review and approve the September 11, 2025, meeting minutes.
Materials and attachments: MCHAP Meeting Minutes - September 11, 2025
Action: Approve the minutes from September 11, 2025
Aye: 12 (Weiss, Hempstead, Arroyo, Latham, Lauterbach, Jacobs, Motadel, Schumann, Salazar, Beck, Beier, Ribordy)
Didn’t Vote: 3 (DiLuigi, Vega, Netherland)
Members Absent: 0
Abstentions: 0
Motion Outcome: Passed
Improving Preventive Care Outcomes in Early Childhood
Тип действия: Информация
Presenter: Pamela Riley, MD, MPH, Assistant Deputy Director and Chief Health Equity Officer, Quality and Population Health Management
Темы для обсуждения:
The presentation provided an overview of efforts to strengthen preventive care for children and youth enrolled in Medi-Cal through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. It highlighted that EPSDT requires comprehensive, age-appropriate health services up to age 21, with a focus on screenings, diagnostics, and treatment. The update noted California’s performance challenges, including lower screening rates for children under age 1 compared to national averages, and outlined barriers, such as eligibility and enrollment issues, data reporting gaps, and access limitations. Best practices and opportunity areas were discussed, including expanding appointment availability, improving data sharing, and enhancing collaboration with partners like Women, Infants, and Children and schools. The presentation also covered DHCS participation in a Centers for Medicare & Medicaid Services (CMS) affinity group and Institute for Healthcare Improvement learning collaboratives aimed at increasing well-child visits and preventive care utilization. Finally, vision screening requirements under EPSDT were reviewed, along with statewide data on eye exam rates and strategies to address gaps in vision care services for children in Medi-Cal.
A member asked about the vision services data, noting that the comprehensive or intermediate exam rates likely reflect optometry data and questioning whether screening data from practices might be underreported due to lack of reimbursement incentives. The member also suggested that parents may not prioritize eye exams unless problems arise and asked for clarification on what the EPSDT screening percentages represent. DHCS responded that the data was provided as a starting point and explained that “screening” refers to any service provided under EPSDT, even a single screening service. DHCS acknowledged that the measure is not highly precise and emphasized the need to investigate whether high “none” rates reflect true lack of services or data issues, enrollment gaps, or access barriers. The member followed up, asking what “other” means in the data table. DHCS responded that they would review and confirm what “other” represents and follow up with clarification at the next meeting.
A member asked whether EPSDT data could be broken down by factors, such as socioeconomic status, language, and family composition, noting that such analysis has previously helped identify disparities and target interventions. The member also raised questions about underlying causes for low screening rates, such as vaccine hesitancy or access barriers, and suggested potential strategies, like leveraging doulas, schools, home visits, or outreach calls when missed visits are identified. DHCS responded that these ideas align with the goals of current collaboratives, which aim to identify barriers and improve care delivery through member and caregiver engagement. DHCS noted that efforts are underway to address challenges, such as newborn enrollment, data collection and sharing, and access improvements. Regarding the EPSDT data categories, DHCS clarified that “screening” refers to any EPSDT service, and “none” means no EPSDT services at all.
A member asked about the importance of looking beyond traditional sources for preventive care data, emphasizing home visits and noting that fear of public spaces has increased since 2023. The member suggested incorporating data from non-well-child visits, such as sick visits where pediatricians often address missed preventive care, even if those services are coded differently. The member stressed the need to capture this additional data to better understand care delivery. DHCS responded that they are actively considering these strategies and exploring ways to maximize opportunities during any type of visit to provide preventive services to children.
A member asked about challenges in accessing vision care, noting that many patients are unaware of how to start the process and suggesting that including the vision plan contact number on benefits cards could help. The member also highlighted confusion caused by varying requirements among plans, such as needing referrals or authorizations, and expressed concern for individuals without support from community health centers who may lack navigation assistance. The member emphasized that these issues present opportunities for improvement. DHCS responded that these suggestions point to opportunities to reinforce vision care access through EPSDT outreach and education efforts.
A member asked whether there is an opportunity to sample individuals in the group showing no EPSDT screening to confirm if they truly received no services or if services were not billed. The member also questioned whether infant enrollment issues contribute to low screening rates and asked if health plans have incentives to enroll infants at birth. Additionally, the member suggested outreach strategies, such as engaging families at community locations like markets and leveraging school partnerships and referencing models from the Children and Youth Behavioral Health Initiative (CYBHI) that incentivize health plans to collaborate with schools and use standardized reimbursement schedules to improve access. DHCS responded by acknowledging the importance of these suggestions and noted that incorporating school-based partnerships into strategies is critical for improving outcomes, particularly for vision screening.
A member asked whether conducting a small pilot sample of families in the group showing no EPSDT screening could help determine if they truly received no services or if services were not billed. The member suggested that gathering direct data from families before implementing solutions would provide valuable insights. DHCS responded that this approach aligns with their goals and noted that the data provided by CMS is not how DHCS typically monitors populations. DHCS explained they focus more on well-child visit measures (e.g., 0–15 months, 15–30 months) and plan to use those measures to identify who needs engagement. DHCS emphasized the importance of member input and creative outreach strategies, which they aim to foster through collaboratives with managed care plans.
A member asked about examining social and geographic barriers to access for children under age 1, suggesting the use of regional data to identify populations that may be more hesitant to seek care or vaccines. The member emphasized the value of modeling these patterns and comparing rural and urban access differences. DHCS responded that they plan to enhance regional analysis capabilities, particularly through Medi-Cal Connect, to identify challenges and use this information to investigate root causes and inform strategies for improving access.
Drug Medi-Cal and Drug Medi-Cal Organized Delivery System: Penetration Rate Data and Discussion
Тип действия: Информация
Presenter: Paula Wilhelm, MPP, MPH, Deputy Director, Behavioral Health; Linette Scott, MD, MPH, Deputy Director and Chief Data Officer, Enterprise Data and Information Management
Темы для обсуждения:
The presentation outlined the scope of Medi-Cal substance use disorder (SUD) treatment services available through Drug Medi-Cal (DMC) and the Drug Medi-Cal Organized Delivery System (DMC-ODS). DMC provides outpatient and residential treatment for youth under age 21 and perinatal women, medications for addiction treatment, and optional services, such as peer support and community health worker programs. DMC-ODS, implemented through managed care, offers an expanded continuum of care aligned with American Society of Addiction Medicine (ASAM) standards, including withdrawal management, recovery services, care coordination, and additional treatment options. The update noted that California’s DMC-ODS waiver, approved in 2015, now covers 40 counties, reaching 96 percent of the state’s population, with more than 120,000 Medi-Cal members receiving at least one SUD service in fiscal year 2022–2023. A penetration rate dashboard published in June 2025 was introduced, showing the percentage of Medi-Cal members who accessed DMC or DMC-ODS services during that period, based on claims data. The discussion emphasized that penetration rates measure service utilization rather than treatment need and highlighted ongoing initiatives and data sources to support improved access and quality of youth SUD treatment in Medi-Cal.
A member expressed appreciation for the shared data, but concern over low utilization rates given national substance use data among youth. The member inquired whether California’s penetration rates have been compared with other states to identify potential best practices and suggested that such comparisons could be valuable. The member also noted optimism about bond measure funding supporting higher-level services for youth with SUDs. DHCS responded that comparing California’s data with other states is a good suggestion and indicated interest in pursuing a follow-up conversation to review such data if it becomes available.
A member asked how California’s various SUD initiatives, such as the California Opioid Response, are being communicated to school districts and county offices of education. The member emphasized that better connections with schools could improve outreach and student access to these resources and noted that they were previously unaware of some initiatives. DHCS responded by acknowledging the importance of connecting schools and education systems to these resources and committed to exploring ways to increase awareness, whether through county delivery systems or other opportunities. DHCS shared that informal surveys of higher-performing counties revealed strong referral relationships with schools as a best practice for reaching more youth.
A member asked about the newly published penetration rate data, expressing appreciation for its transparency, but concern over low utilization despite significant investments in infrastructure and workforce. The member raised multiple policy and operational questions, including the adequacy of DMC reimbursement rates, parity between SUD and mental health systems, and the need for regulatory updates to align with ASAM service definitions. Additional points included strengthening school-based partnerships, improving integration with primary care and Federally Qualified Health Centers (FQHC), addressing siloed data systems, and investing in electronic health records beyond billing systems. DHCS responded by acknowledging these concerns and outlined plans to use penetration rate data to inform Behavioral Health Services Act implementation, including developing statewide population health goals and performance measures focused on reducing overdoses and untreated behavioral health conditions. DHCS noted that recent payment reform efforts equalized outpatient rates between DMC and specialty mental health for similar practitioner types, but agreed more work is needed to achieve full parity and flexibility for treating co-occurring conditions. DHCS emphasized that the published data serves as a foundation for future strategies and performance measurement.
A member expressed appreciation for DHCS’ transparency in presenting gaps and inviting stakeholder input, noting DHCS’ courage in doing so. The member suggested strategies to increase penetration rates, emphasizing youth engagement through peer health promoters and social media outreach. They proposed creating roles for youth in schools that could earn credit and highlighted the need for statewide leadership to engage FQHC leadership to strengthen partnerships. Additional points included addressing stigma, improving care coordination between counties and caregivers, ensuring follow-up after hospitalization, and exploring incentives for better integration. The member also recommended statewide Narcan training for all staff as part of required workplace training. DHCS responded by agreeing that youth engagement is critical and noted that establishing a youth advisory panel is being considered as a strategy for improving program success. DHCS also acknowledged the importance of care coordination and shared that counties can contract directly with FQHCs for DMC services, though complexities exist due to payment structures. DHCS highlighted efforts to improve data exchange between Medi-Cal managed care plans and county behavioral health plans, citing updates to federal interoperability standards and 42 Code of Federal Regulations (CFR) Part 2 regulations as steps toward better integration and real-time information sharing.
A member asked about the recurring challenges related to data capture and interoperability, noting that discussions often focus on DHCS and CMS responsibilities rather than the role of electronic medical record (EMR) vendors. The member suggested that EMR vendors should be more involved in data sharing and interoperability efforts and proposed exploring a statewide contract to support rural and smaller practices with robust EMR systems, which could improve data collection and integration. DHCS responded that these issues are being addressed through California’s Data Exchange Framework, which establishes statewide data sharing agreements and policies. DHCS noted that recent oversight of the framework moved to the Department of Health Care Access and Information (HCAI), which is working to institutionalize and strengthen these efforts. DHCS also mentioned rural health grants as part of infrastructure support and highlighted reliance on CMS interoperability rules and funding to help counties comply. Additionally, DHCS referenced the California Mental Health Services Authority’s exploration of shared resources for behavioral health data exchange. Another member added that many FQHCs and providers in rural counties are transitioning to Epic, which improves interoperability within their network but remains siloed from mental health, DMC, and school systems. They noted that while health plans can access data through health information exchanges, provider-to-provider exchange is still limited, and achieving full integration remains the goal.
A member expressed appreciation for the report and the availability of penetration rate data, noting that stakeholders have wanted this information for a long time. The member suggested that future efforts include demographic analysis to identify which populations are accessing treatment and which are not, emphasizing concerns about disparities and the criminalization of SUDs among certain populations, particularly Black and Brown youth. The member also recommended partnering with family resource centers and caregiver-facing organizations to educate families about treatment rights and reduce fear of child welfare involvement, which can be a barrier to seeking care. DHCS responded by agreeing that stratifying data to identify disparities is important and noted that counties have requested more frequent updates and clear goals to work toward. DHCS acknowledged that stigma and concerns about social consequences remain significant barriers for youth and families seeking treatment.
A member commented on challenges with using DMC-ODS systems, noting that while FQHCs are certified, the interface is complex and duplicative. They highlighted issues with data collection and multiple steps, such as screening and assessment, and stated that there is no flexibility or interoperability between systems. The member emphasized the need to involve individuals with technology expertise to address these barriers, as they affect the continuum of care.
A member asked about low reimbursement rates for detoxification services, noting that hospitals often avoid establishing detox units because reimbursement is insufficient. They shared that detoxification typically occurs in general hospitals by default and questioned how these services are billed. The member also raised a broader question about state-level coordination among agencies to optimize SUD treatment, referencing Proposition 64 funding for youth leadership groups and other funding streams, such as opioid settlement funds. DHCS responded by acknowledging the connection to Proposition 64 programs, which focus on youth prevention and operate outside of DMC billing. DHCS explained that these programs, along with block grant-funded initiatives, are distinct but include referral pathways to connect youth and families to care when needed. DHCS agreed that examining coordination and identifying missed opportunities would be valuable to improve outcomes and increase engagement.
The California Child and Adolescent Mental Health Access Portal (Cal-MAP)
Type of Action: Information
Presenter: Petra Steinbuchel, MD, Director, University of California, San Francisco, Cal-MAP
Темы для обсуждения:
The presentation introduced Cal-MAP, a program under the CYBHI designed to support primary care providers in assessing and treating mental and behavioral health conditions for youth ages 0–25. It highlighted the growing youth mental health crisis, noting that one in five children have a diagnosable condition and many face long delays in receiving care. Cal-MAP addresses these gaps through real-time telephonic and electronic consultations, care coordination, and training for providers, enabling timely access to evidence-based care in primary care and school-based settings. The program offers “curbside” consultations with child psychiatrists and specialists, resource navigation, and continuing education, including webinars and boot camps on topics, such as Attention-Deficit/Hyperactivity Disorder, depression, and anxiety. The initiative aims to advance equity and reduce wait times. It also aligns with statewide behavioral health goals by promoting earlier intervention and reducing reliance on emergency or specialty care.
A member asked how apps like BrightLife and Soluna are being integrated into practice and whether referrals to these platforms are effective. The speaker responded that these programs, along with other CYBHI resources, are hosted on the main website and used for referrals when clinically appropriate. Typically, consults involve higher levels of need, so youth platforms are helpful for lower-need cases or as a bridge, while higher-need cases may require intensive outpatient or partial hospitalization care.
A member asked how Cal-MAP regionalizes its response so that questions from a specific county are addressed by personnel familiar with that area. The speaker responded that Cal-MAP partners with regional sites, such as Children’s Hospital of Orange County, UC Irvine, UC Riverside, and San Diego to ensure faculty and care coordinators understand local nuances. They noted that proximity improves engagement, citing Massachusetts data showing fewer calls when support is distant. Most calls currently come from the Bay Area, but regional partnerships and boot camps are increasing participation in other areas.
A member asked about expanding Cal-MAP training to family medicine providers, noting its value for supporting next steps when primary care or family doctors encounter mental health concerns. The speaker responded that there is strong interest from family medicine, citing engagement at the Family Medicine Preventive Practice annual conference. Cal-MAP has already registered several family medicine training programs and plans to expand further.
2026 Chairperson Election
Type of Action: Action
Recommendation: Nominate and elect the 2026 Chairperson
Presenter: Michelle Baass, Director, opened the floor for statements for the 2026 Chairperson.
Materials and Attachements:
Action: Two members (Nancy Netherland and Kenneth Hempstead, M.D.) expressed interest in serving as Chairperson.
Nancy Netherland: 10 (Netherland, Latham, Lauterbach, Motadel, Schumann, Beck, Salazar, Vega, Beier, Ribordy)
Kenneth Hempstead, M.D.: 5 (Weiss, Hempstead, DiLuigi, Jacobs, Arroyo)
Motion Outcome: Nancy Netherland was elected as the 2026 Chairperson.
Обновление от директора
Тип действия: Информация
Presenter: Tracy Arnold, Assistant Director
Темы для обсуждения:
The presentation provided updates on key initiatives and policy changes impacting Medi-Cal. It highlighted the federal CMS Access Final Rule, which requires formal stakeholder engagement and transparency, including the establishment of two advisory groups: the Medi-Cal Member Advisory Committee and the Medi-Cal Voices and Vision Council. These groups will advise on services and policy, with the first council meeting held in September 2025 and annual reporting beginning in July 2026. The update also introduced a redesigned online experience for Medi-Cal members, featuring a mobile-friendly, accessible, and multilingual website that offers benefit information, application links, and a new Help Center with resources, such as county office locators and Frequently Asked Questions (FAQ). Additional resources were shared on asset limits and upcoming changes for specific member groups. Legislative highlights from the 2025 session included bills expanding access to field medicine for individuals experiencing homelessness, strengthening the Community Assistance, Recovery, and Empowerment Court program, extending time and distance standards for Medi-Cal services, updating statewide immunization guidelines, and exempting certain foster youth from enrollment restrictions.
A member asked for an update on outreach efforts to inform individuals losing eligibility for full-scope Medi-Cal starting January 1, requested clarity on timelines for impacted immigrant populations (e.g., asylees), and suggested improving data coordination for field medicine services to support implementation of the new legislative bill. DHCS responded that notices and FAQs have been mailed to Medi-Cal members and posted online, with links available for reference. DHCS noted that some health plan associations have also created materials leveraging this information to help communicate changes. Additionally, DHCS is developing a simplified table to clarify which populations are affected and when changes occur, including the enrollment freeze in January and removal of dental benefits in July 2026. Further resources will be shared once finalized.
A member asked for clarification on the implementation of the field medicine bill, specifically whether managed care plans (MCPs) will contract directly with field medicine providers. DHCS responded that the bill allows MCPs to contract with field medicine providers and also permits individuals experiencing homelessness to receive care from those contracted providers.
Публичный комментарий
Type of Action: Public Comment
Темы для обсуждения:
Krstine Shultz, Executive Director, California Optometric Association, emphasized the need for improved data tracking related to school vision screenings. She recommended that the state collect data on when children receive screenings, who is referred for an exam, and how many complete the exam and receive glasses, broken down by location and demographics, to identify disparities. She cited statistics from Prevent Blindness indicating that between 5% and 50% of children do not receive follow-up exams after failing a vision screening. Shultz highlighted the importance of vision care, noting that 80% of learning is processed through vision, and at least one in four school-aged children have vision problems, yet only 17% receive an eye exam. She urged Medi-Cal to cover evidence-based options for high myopia, stressing that untreated myopia can lead to irreversible pathology. Additionally, she noted that school and pediatric screenings do not assess factors, such as focusing ability, depth perception, and eye health, and advocated for comprehensive eye exams for all children. Shultz shared that her organization’s Children’s Vision Committee includes pediatric experts and expressed interest in partnering with DHCS to improve access to vision care.
Doug Major, OD, shared that his committee includes an expert who founded a vision care coalition at Harvard, offering best practices that could be applied in California. He noted that current vision-related data points are limited and emphasized the need for more comprehensive surveillance. Major expressed appreciation for outreach efforts by Deputy Director Scott and collaboration with Cal Poly’s public health data team and CenCal Health since the last meeting. He raised concerns about the lack of vision care data, stating that responsibility is fragmented across specialties and urging DHCS to provide top-down leadership. Switching to his perspective as a provider, Major described challenges in contacting DHCS regarding the loss of benefits under the Prison Industry Authority (PIA), citing multiple unanswered calls and emails before receiving a response from legal counsel. He criticized systemic issues, noting that the prison system controls children’s vision care and referenced AB 579, which allowed firefighters to exit the system while children remained subject to its limitations. Major urged DHCS to advocate for children’s vision care. Finally, he highlighted the importance of addressing brain injuries among youth in juvenile systems, citing data from Colorado indicating 60–70% prevalence. He suggested that eye movement diagnostics could help identify and treat these injuries, improving behavioral outcomes.
Jaylin Pinasco spoke on behalf of the Cal Poly Public Health Data team, which operates under the direction of Dr. Ventura and collaborates with the California Children’s Vision Now Coalition. She shared firsthand experience conducting school vision screenings across the Central Coast, noting significant gaps in access to eye care for children. During a recent screening in San Ardo, more than 60% of elementary students were found to have vision disorders, primarily astigmatism and farsightedness, with many never having received an eye exam. Pinasco emphasized that these findings align with statewide data showing California ranks last nationally for children’s access to vision care. She highlighted the critical role of school nurses in early detection and prevention. Pinasco requested that DHCS release public data on children’s vision care to Cal Poly’s team and support the Children’s Vision Care Public Health Metrics Act to help close this preventable care gap. She also invited attendees to follow the coalition’s work via its YouTube channel for updates and data briefings.
Member Updates
Type of Action: Information
Темы для обсуждения:
Members thanked Dr. Weiss for his leadership and congratulated Nancy on her election as the 2026 Chairperson.
A member commented that they were pleased to have a community member serving as Chairperson, calling it a positive step for the group. They also reiterated concerns about outreach to individuals who may lose Medi-Cal benefits, urging continued efforts to ensure those affected have an opportunity to maintain coverage before January 1. The member expressed appreciation for everyone’s work and encouraged the group to keep up their efforts.
Upcoming MCHAP Meeting and Next Steps
Тип действия: Информация
Presenter: Mike Weiss, M.D., Chair
Темы для обсуждения:
Dr. Weiss thanked members for their support over the past two years, noting that he has learned a great deal and is inspired by their passion and long-standing commitment to volunteering. He also expressed appreciation to DHCS staff for their support and patience as the group continues to learn about Department initiatives.
The next meeting is scheduled for March 18, 2026.
MCHAP will continue to be a hybrid meeting until further notice.
Закрытие заседания
Name of person who adjourned the meeting: Michael Weiss, M.D., Chair
Time Adjourned: 2 p.m.
