Whole Person Care Pilots
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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. Through collaborative leadership and systematic coordination among public and private entities, WPC Pilot entities will identify target populations, share data between systems, coordinate care real time, and evaluate individual and population progress – all with the goal of providing comprehensive coordinated care for the beneficiary resulting in better health outcomes.
$20 Million One-Time Funding for Counties to Initiate Future WPC Pilots
California has successfully worked with twenty-five (25) Whole Person Care Pilot programs to provide target populations with a range of comprehensive services and supports to address unmet needs and improve the quality and outcomes of high-risk populations. The Department of Health Care Services (DHCS) is releasing guidance related to the 2019-20 Governor's Budget investment of $20 million from the Mental Health Services Fund to encourage additional counties to initiate Whole Person Care-like pilot capacity with this one-time funding allocation. Interested counties may click the link below for more information and instructions on how to apply.
$100 Million One-Time Housing Funding for WPC Pilots
The 2019-20 Governor’s Budget invests $100 million State General Fund (one-time with multi-year spending authority through June 30, 2025) for active Whole Person Care (WPC) Pilot programs that provide housing services. The WPC Pilot program coordinates health, behavioral health and social services in a patient-centered manner with the goal of improved beneficiary health and well-being. Many of these pilot programs target individuals who are mentally ill and are experiencing homelessness or who are at risk of homelessness, and have a demonstrated medical need for housing and/or supportive services.
CMS Approval of WPC City Amendment and Second Round of Pilot Applications
On June 1, 2017, the Centers for Medicare and Medicaid Services (CMS) approved an amendment to the Special Terms and Conditions of California's
Medi-Cal 2020 Demonstration for the WPC pilots program. The technical amendment
enables the State to accept applications from and designate a city to be a lead entity for the WPC Pilot Program.
On June 8, 2017, CMS also approved the second round of WPC pilot applications. CMS find the applications from the specific counties and city to be in accordance with the Medi-Cal 2020 Demonstration Special Terms and Conditions (STCs) and approval protocols for the WPC program. The approved pilots are listed in CMS' approval letter below.
Resources and Information
In 2016, DHCS completed a first round WPC application process and approved 18 lead entities to operate WPC pilots.
In early 2017, DHCS conducted a second application process to expand current pilots and/or approve additional entities to operate WPC pilots.
Publications & Reports
Attachment GG - WPC Reporting and Evaluation: Mid-year and annual reporting requirements and evaluation process
Attachment HH - WPC Pilot Requirements and Application Process: Application submission and review process, pilot funding, termination process, and WPC Learning Collaboratives
Attachment MM - WPC Pilot Requirements and Metrics: Performance metrics (universal and variant), incorporation of Plan-Do-Study-Act (PDSA), and reporting requirements
CMS Approval Letter of Attachments GG, HH, MM, and the Application Criteria (May 13, 2016)
CMS Approval Letter of Attachment MM: Pilot Requirements and Metrics (October 21, 2016)Frequently Asked Questions and Answers (Updated July 11, 2018)
Comparison of Whole Person Care (WPC) Pilots, Health Homes Program (HHP), Coordinated Care Initiative (CCI), and Public Hospital Redesign and Incentives in Medi-Cal (PRIME)
Whole Person Care Pilot Overview
Whole Person Care Applications Statistics (updated February 2019)
Approved Whole Person Care Pilot Applications
WPC Final Evaluation Design |
CMS Approval Letter
Harbage WPC Mid-Point Review Paper (March 2019)
Lead Entity Narrative Reports
WPC Enrollment Reports
WPC Progress Reports
Learning Collaborative Reports
*Please note that the Budget Summary Templates and Samples are ADA-compliant documents, which have limited functionality due to certain modifications. Please send a request to the WPC Program Inbox at 1115WholePersonCare@dhcs.ca.gov to receive the fully-functional version of the template and sample.
Past Stakeholder Webinars
Please direct your comments, questions or suggestions regarding the Whole Person Care Pilots to the following email address: 1115WholePersonCare@dhcs.ca.gov