All Programs and Services
Listed below are all programs and services offered by the Department of Health Care Services.
A
American Indian Infant Health Initiative
Provides extensive home visiting/case management services to high-risk American Indian families.
Assisted Living Waiver (ALW)
The ALW is the Medi-Cal program that pays for specific assisted living benefits provided to eligible beneficiaries residing in Sacramento, San Joaquin, Los Angeles, Sonoma, Fresno, San Bernardino or Riverside county.
Audits & Investigations
Audits and Investigations (A&I) is the designated Program Integrity Unit for California’s Medicaid program – Medi-Cal. A&I’s mission is to protect and enhance the integrity of the health programs administered by DHCS.
B
Behavioral Health Treatment (BHT)
The State of California intends to provide BHT services as a covered Medi–Cal benefit for individuals under 21 years of age with autism spectrum disorder.
Breast and Cervical Cancer Treatment
Free screening for breast and cervical cancer.
C
CalABLE
Medi-Cal members may be eligible for CalABLE, the state’s savings program for people with disabilities. CalABLE helps individuals save without impacting benefits like Medi-Cal and Supplemental Security Income.
California Children’s Services
Treatment for children with chronic or life-threatening health conditions and diseases.
Child Health and Disability Prevention
Preventive health program for low-income children and youth.
Children’s Medical Services
Provides a comprehensive system of health care for children through preventive screening, diagnostic, treatment, rehabilitation, and follow-up services.
D
Drug Medi-Cal (DMC)
Provides counties and direct providers with important information about the requirements of the California Code of Regulations, Title 22, Section 51341.1 and the standards applicable to substance abuse treatment reimbursable through DMC.
E
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services
DHCS is responsible for providing full-scope Medi-Cal beneficiaries under the age of 21 with a comprehensive, high-quality array of preventive (such as screening), diagnostic, and treatment services under EPSDT.
EHR Incentive Program
In 2011, eligible Medi-Cal professionals and hospitals began to receive incentive payments to assist in purchasing, installing, and using electronic health records in their practices.
Estate Recovery
Recovers Medi-Cal expenditures from the estates of certain deceased Medi-Cal beneficiaries for services received on or after the individual’s 55th birthday.
Every Woman Counts (EWC)
The mission of the EWC is to save lives by preventing and reducing the devastating effects of cancer for Californian women.
F
Fair Hearing
Complaints about how Medi-Cal benefits and services are/were handled, or if services have been denied or modified.
Family Planning, Access, Care and Treatment
Comprehensive family planning services to eligible low-income men and women.
Fraud and Abuse
Report Medi-Cal Fraud
G
Genetically Handicapped Persons Program
Treatment for specific genetic diseases.
Gynecologic Cancer Information Program (GCIP)
GCIP was established to increase awareness and education regarding gynecologic cancers.
H
Health Care Program for Children in Foster Care
Provides medical, dental, mental and developmental services to children and youth in foster care.
Health Information Management Division (HIMD)
HIMD supports Department-wide efforts for accurate and timely information that supports DHCS programs.
Health Insurance Premium Payment
Program that pays private health insurance premiums for certain high cost Medi-Cal beneficiaries.
High Risk Infant Follow-Up
Limited diagnostic services for children up to three years of age.
HIPAA (Health Insurance Portability and Accountability Act)
The HIPAA Privacy regulations require health care providers and organizations to follow procedures that ensure the confidentiality and security of protected health information (PHI) when it is transferred, received, handled, or shared.
Home and Community-Based Services for the Developmentally Disabled (HCBS-DD)This waiver authorizes home and community-based services for developmentally disabled persons who are Regional Center consumers.
Hospital Quality Assurance Fee
This program provides funding for supplemental payments to California hospitals that serve Medi-Cal and uninsured patients.
I
In-Home Supportive Services Plus Waiver
Personal care and domestic services to persons who are aged, blind or disabled and who live in their own homes.
Indian Health Program
Program to improve the health status of American Indians/Alaska Natives (AI/AN) living in urban, rural, and reservation or rancheria communities throughout California.
Intermediate Care Facility for the Developmentally Disabled-Continuous Nursing (ICF/DD-CN)
The waiver requires the Department to commit to maintaining access to care, provision of quality services, adhering to cost effectiveness, and open access to emergency services for the target population eligible for services under the waiver.
L
Legislative and Governmental Affairs
Facilitates, coordinates, and advocates for the development of legislation in the interest of public health.
Long-Term Care
Increases the number of middle-income Californians who have quality long-term care insurance that prevents or delays their dependence on Medi-Cal.
M
Major Risk Medical Insurance Program (MRMIP)
This program provides health insurance for Californians unable to obtain coverage in the individual health insurance market because of their pre-existing conditions.
Medi-Cal
This is a public health insurance program which provides needed health care services for low-income individuals and families.
Medi-Cal Access Program
The Medi-Cal Access Program (MCAP) (formerly Access for Infants & Mothers (AIM) program) provides low cost health insurance coverage to uninsured, middle income pregnant women.
Medi-Cal Dental Program
The program covers a variety of dental services for eligible Medi-Cal beneficiaries through two delivery systems – Dental Fee-for-Service and Dental Managed Care.
Medi-Cal Eligibility Division
Division is responsible for the coordination, clarification, and implementation of Medi-Cal regulations, policy, and procedures to assure that Medi-Cal eligibility is determined accurately and on a timely basis by the 58 county public social services agencies.
Medi-Cal Managed Care
Contracts for health care services through established networks of organized systems of care, which emphasize primary and preventive care.
Medi-Cal Waivers
Waivers are programs that demonstrate and evaluate new health care delivery systems. These programs focus on reducing costs and providing services in a community based setting.
Medical Therapy
Occupational Therapy and Physical Therapy for children with eligible conditions.
Mental Health and Substance Use Disorder Services (MHSUDS)
Multipurpose Senior Services Program (MSSP) Waiver
The MSSP waiver is targeted to those medically fragile individuals over the age of 65 and is administered through MSSP sites throughout the state, under the California Department of Aging.
N
Newborn Hearing Screening
Helps identify hearing loss in infants, and guide families to the appropriate services needed to develop communication skills.
Newborn Screening
Testing for specific genetic disorders.
O
Office of Communications
The Office of Communications is responsible for the overall communications and outreach activities.
Office of Family Planning
Comprehensive family planning services to eligible low income men and women.
Ombudsman
An Ombudsman is a person in a government agency to whom people can go to make complaints or explain problems with the programs or policies of the agency.
Overpayments
The primary function is to recover funds due the Medi-Cal program.
P
Personal Injury
The Personal Injury Unit is responsible for the recovery of Medi-Cal expenditures in personal injury actions involving Medi-Cal beneficiaries.
Pharmacy Benefits and Vision Care Services
Medi-Cal Pharmacy Benefits include Fee-For-Service Drug Program, Drug Rebate Program, Enteral and Medical Supplies Contracting, Drug Contracting, and Vision Care.
Presumptive Eligibility for Pregnant Women
Allows Qualified Providers to grant immediate, temporary Medi-Cal coverage for outpatient prenatal care and prescription drugs for conditions related to pregnancy to low-income, pregnant patients, pending their formal Medi-Cal application.
Primary, Rural, and Indian Health
Improve the health status of special, targeted population groups living in medically underserved urban and rural areas of California.
Program of All-Inclusive Care for the Elderly (PACE)
The PACE model of care provides a comprehensive medical and social service delivery system using an interdisciplinary team approach that provides and coordinates all needed preventive, primary, acute and long term care services
Proposition 56
Proposition 56, passed by the voters in November 2016, increases the excise tax rate on cigarettes and electronic cigarettes, effective April 1, 2017, and other tobacco products effective July 1, 2017
Public Clinics
This voluntary Certified Public Expenditure based program provides additional funding to eligible governmental entities that provide Clinic services to Medi-Cal beneficiaries.
S
Senior Care Action Network (SCAN)
SCAN Health Plan is a Medicare Advantage Special Needs Plan that provides all services in the Medi-Cal State Plan. Participants must be 65 years or older, Medi-Cal and Medicare eligible and reside in the SCAN service area.
Subacute Care Program
Specific reimbursement rates have been developed for providers of subacute care who have been licensed and certified by the CA Department of Public Health’s Licensing and Certification program.
V
Vision Care Services and Pharmacy Benefits
Medi-Cal Pharmacy Benefits include Fee-For-Service Drug Program, Drug Rebate Program, Enteral and Medical Supplies Contracting, Drug Contracting, and Vision Care.
Veterans Benefits Enhancement Project
The Department of Health Care Services (DHCS) Veterans Benefit Enhancement (VBE) project helps veterans who are receiving Medi-Cal Services obtain veteran benefits they are entitled to.
W
Whole Person Care Pilots
The overarching goal of the Whole Person Care (WPC) Pilots is the coordination of health, behavioral health, and social services, as applicable, in a patient-centered manner with the goals of improved beneficiary health and wellbeing through more efficient and effective use of resources. WPC Pilots will provide an option to a county, a city and county, a health or hospital authority, or a consortium of any of the above entities serving a county or region consisting of more than one county, or a health authority, to receive support to integrate care for a particularly vulnerable group of Medi-Cal beneficiaries who have been identified as high users of multiple systems and continue to have poor health outcomes.
Women, Infants and Children (WIC)
Nutrition program that helps pregnant women, new mothers and young children eat well and stay healthy.
Workers Compensation Recovery Program
Responsible for identifying and recovering Medi-Cal expenditures made on behalf of beneficiaries whose injuries are covered by Workers Compensation liability.
Working Disabled Program
Allows certain individuals to become eligible for Medi-Cal by paying low monthly premiums based on countable income.