​​​​​​​​​​​​​​​1915(b) Medi-Cal Specialty Mental Health Services Waiver

California's 1915(b) SMHS Waiver renewal was approved for a five-year term, July 1, 2015, through June 30, 2020, and includes Special Terms and Conditions (STCs). The STCs are included in the Centers for Medicare & Medicaid Services’ (CMS) approval letter below and aim to improve program integrity, monitoring, and compliance. Among other requirements, the STCs require the posting of county mental health plan (MHP) performance data (dashboards), Plans of Correction, and Quality Improvement Plans on the DHCS website.

 

On March 23, 2021 CMS approved DHCS’ request for a temporary extension of the Medi-Cal SMHS 1915(b) waiver program through December 31, 2021. This extension allows DHCS time to develop and obtain approval for specific California Advancing and Innovating Medi-Cal (CalAIM) initiatives, and to align with the proposed one-year extension of the Section 1115 demonstration (Medi-Cal 2020). CalAIM is a multi-year Department of Health Care Services (DHCS) initiative to implement overarching policy changes across all Medi-Cal delivery systems. Throughout 2019 and 2020, DHCS conducted extensive stakeholder engagement for both CalAIM and the Medicaid Section 1115 demonstration renewal. 

DHCS submitted the CalAIM Section 1915(b) waiver application​ to CMS. The application is a renewal and amendment to the SMHS Section 1915(b) waiver – called the CalAIM Section 1915(b) waiver – that includes the SMHS program, as well as streamlined authorization for Medi-Cal managed care, dental managed care, and the Drug Medi-Cal Organized Delivery System (DMC-ODS). DHCS is requesting approval by December 2021 to enable implementation in January 2022.

For more information about the CalAIM initiatives and stakeholder engagement process, please visit the CalAIM homepage and CalAIM 1115 Demonstration & 1915(b) Waiver webpage.