Stakeholder Advisory Committee (SAC) and Behavioral Health Stakeholder Advisory Committee (BH-SAC) Joint Meeting Summary
Date: Wednesday, October 29, 2025
Time: 9:30 a.m. – 3 p.m.
DHCS Staff Presenters: Michelle Baass, Director; Tyler Sadwith, State Medicaid Director; Sarah Crow, Chief, Medi-Cal Eligibility; Rafael Davtian, Deputy Director, Health Care Financing; Lemeneh Tefera, MD, MSc, Chief Medical Officer, California Department of Health Care Access and Information (HCAI); Lauren Gavin Solis, Chief, Office of Medicare Innovation and Integration; Ivan Bhardwaj, Chief, Medi-Cal Behavioral Health Policy Division; Erika Cristo, Assistant Deputy Director, Behavioral Health; Paula Wilhelm, Deputy Director, Behavioral Health; Glenn Tsang, Policy Advisor, Homelessness & Housing; Katherine Barresi, RN, Chief Health Services Officer, Partnership HealthPlan of California; Amy Ellis, MFT, Adult System of Care Division Director, County of Placer Health and Human Services
SAC Members in Attendance: Adam Dorsey, Al Senella, Amanda Flaum, Anna Leach-Proffer, Beth Malinowski, Brianna Pittman-Spencer, Carlos Lerner, Carlos Marquez III, Chris Perrone, Christine Smith, Faith Colburn, Janice Rocco, Jarrod McNaughton, Katie Rodriguez, Kim Lewis, Kiran Savage-Sangwan, Le Ondra Clark Harvey, Linda Nguy, Marina Owen, Michelle Cabrera, Michelle Gibbons, Rosario Arreola Pro, Ryan Witz, William Walker
BH-SAC Members in Attendance: Al Senella, Carlos Marquez III, Kim Lewis, Kiran Savage-Sangwan, Le Ondra Clark Harvey, Michelle Cabrera, William Walker, Adrienne Shilton, Angela Vasquez, Catherine Teare, Dannie Ceseña, Hector Ramirez, Jason Robinson, Jei Africa, Jessica Cruz, Jevon Wilkes, Karen Larsen, Kirsten Barlow, Linnea Koopmans, Robert Harris, Rose Veniegas, Samuel Jain, Sara Gavin, Veronica Kelley, Vitka Eisen
Additional Information: Please refer to the PowerPoint presentation used during the meeting for additional context and details.
Introduction and Summary of Content
The joint SAC/BH-SAC meeting addressed topics related to Medi-Cal and California’s behavioral health landscape. Panel members received a Director’s Update on Medi-Cal initiatives, legislative changes, and behavioral health transformation efforts. The following topics were covered during the meeting:
H.R. 1 Update
2026 Expansion of Medi-Medi Plans
Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Policy and Implementation Updates: High Fidelity Wraparound Policies and More
Thuê chuyển tiếp
The meeting concluded with a public comment period, allowing attendees to offer feedback to DHCS and panel members.
Topics Discussed
Cập nhật của giám đốc
Michelle Baass, Giám đốc
DHCS, opened the meeting by providing an update on key initiatives and legislative changes. DHCS highlighted the launch of a new Medi-Cal microsite (my.medi-cal.ca.gov) offering a clean, accessible, mobile-friendly, and multilingual experience to help members and prospective members learn about benefits, check eligibility, apply for coverage, and maintain coverage. The microsite includes a new Help Center with FAQs, guides, and resources on such topics as asset limits, immigration status, and eligibility rules, as well as additional tools like the county office locator and member help lines. Legislative updates from the 2025 session included Assembly Bill (AB) 543 to expand field medicine services for homeless populations, Senate Bill (SB) 27 to strengthen CARE Court eligibility, SB 530 to extend time/distance standards, and AB 144 to update immunization guidelines and exemptions for foster youth. Behavioral health transformation efforts continue with Behavioral Health Continuum Infrastructure Program (BHCIP) Round 2 applications, Behavioral Health Services Act (BHSA) Module 4 for public comment, and county Integrated Plans supported by training and technical assistance. The presentation also addressed community engagement through webinars and new resources, including the new Understanding The BHSA: Myths vs. Reality guidance about the BHSA, emphasizing its broader role beyond Medi-Cal members.
Discussion
A member inquired about the newly posted Integrated Plan dated October 30, asking what changes were made since some counties are nearly finished with their plans. DHCS responded that they did not have details on the changes and would follow up later. The member also noted that while the Myths vs. Reality website is technically correct, the guidance lacks nuance—counties can do more than Medi-Cal across funding sources, but shifts under BHSA will redirect about $1 billion into housing, which cannot be leveraged under Medi-Cal. This shift, combined with entitlement obligations and new Evidence-Based Practices (EBP) requirements, forces counties to reprioritize, creating practical challenges beyond technical allowances. The member emphasized that feedback reflects policy impacts rather than just technical details.
A member thanked DHCS for its work on reinstatement implementation and asked if DHCS plans to conduct outreach to inform immigrants that they must apply by year-end to maintain full-scope Medi-Cal, including timing for mailings. DHCS responded that while there is no targeted campaign for unenrolled immigrants, existing coverage materials are being used for general outreach. For current members who may be affected, direct mailings explaining changes and steps to maintain coverage will be sent in November. DHCS also clarified that the Integrated Plan dated October 30 had no policy changes—only the removal of footnotes for ADA compliance.
A member expressed concern about immigrants losing Medi-Cal coverage and asked if DHCS plans to issue guidance or encourage counties to use local funds to serve this population, given their behavioral health needs and misinformation about what services counties can provide. They also suggested assessing immigrant needs through data and being proactive to prevent gaps in care. DHCS responded that counties can continue using BHSA, grant, and realignment dollars for anyone who seeks care, and there is no change in policy. However, DHCS does not plan to issue guidance specific to immigration, as priorities are based on community needs and the 14 goals outlined in the bill. They emphasized that the community planning process is the best opportunity for local stakeholders to identify and advocate for these needs.
A member thanked DHCS for updates and praised DHCS’ efforts to develop member-facing materials and online resources, noting the importance of clarity, especially regarding terminology differences that can cause confusion for immigrant populations. They expressed appreciation for SB 530 and its role in improving access and reducing exceptions, while emphasizing ongoing concerns about access. The member also highlighted the significance of the exemption for non-minor dependents from Unsatisfactory Immigration Status (UIS) and premiums, mentioning plans to share information and asking if the state has communicated this exemption to child welfare workers through the California Department of Social Services (CDSS) or other channels. DHCS agreed it was a good suggestion and said it would follow up to ensure clear communication of the exemption.
A member acknowledged reviewing the Myths vs. Reality website and echoed concerns about the $1 billion shift from services to housing, emphasizing the need to address gaps for undocumented individuals and ensure counties can navigate these complexities. They stressed the importance of strong coordination with Medi-Cal managed care plans (MCP) to align services effectively. DHCS responded by highlighting opportunities for counties to maximize Medi-Cal billing, noting that if all counties performed at high levels, an additional $1 billion in federal funding could be drawn down statewide. This underscores the focus on leveraging federal dollars and optimizing revenue as priorities shift and new benefits emerge.
A member criticized the lack of accountability in stakeholder engagement, noting that accessibility and safety for immigrant communities and individuals with disabilities are not enforced despite being outlined in policy. They expressed concern about stigmatizing language and hostile environments, including reports of clinic staff calling immigration, and urged the state to provide clear guidance and protections rather than deflect responsibility to counties. The member warned of worsening conditions, such as food insecurity and increased risks after November, and called for urgent state leadership to ensure equitable access to services and safeguard vulnerable populations.
A member thanked the state for its inclusivity and helpful update calls, but raised concerns on behalf of providers about the impact of policy changes on clients with complex behavioral health needs. They cited worries over the shortened eligibility redetermination period, shifting funding priorities, and inconsistencies in the Myths vs. Reality materials, which could create confusion for counties and providers. The member emphasized the urgent need for clear, timely guidance and strong communication to support collaboration between providers, counties, and plans.
A member expressed appreciation for DHCS’ vision for integrated planning, highlighting its value in combining public health, behavioral health, and managed care efforts during challenging times. They noted that integrated planning helps stretch resources and expand coverage, making it a bright spot amid current difficulties. The member encouraged meaningful engagement in the planning process to realize its full potential and acknowledged its importance for achieving coordinated, impactful outcomes.
H.R. 1 Update
Michelle Baass, Director; Tyler Sadwith, State Medicaid Director; Sarah Crow, Chief, Medi-Cal Eligibility; Rafael Davtian, Deputy Director, Health Care Financing; Lemeneh Tefera, MD, MSc, Chief Medical Officer, HCAI
DHCS provided an in-depth update on the implementation of H.R. 1 and its impact on Medi-Cal, outlining major policy changes, timelines, and guiding principles. Key provisions include new eligibility and access requirements, such as six-month redeterminations, shortened retroactive coverage, and mandatory work reporting requirements for expansion adults starting January 1, 2027, with detailed exemptions and hardship provisions. Payment and financing reforms restrict provider taxes, cap State Directed Payments (SDP) at Medicare levels with a phasedown beginning in 2028, while immigrant coverage changes end federal funding for certain noncitizens and adjust emergency Medi-Cal funding. The presentation emphasized automation, clear communication, and streamlined renewal processes to protect coverage, along with robust outreach strategies in multiple languages and training for county workers. It also detailed compliance verification through state and federal data sources, phased outreach campaigns, and evolving federal rules for SDPs, including the Centers for Medicare & Medicaid Services (CMS) guidance on grandfathering and evaluation plans. Overall, the update underscored DHCS’ commitment to equity, transparency, and readiness as it navigates significant federal and state policy shifts.
HCAI partnered with DHCS to provide an update on the Rural Health Transformation Program (RHTP), which allocates $50 billion over five years to improve health care access, quality, and outcomes in rural communities through workforce development, technology adoption, and innovative care models. Priorities include telehealth expansion, infrastructure modernization, and maternal health improvements, supported by stakeholder input emphasizing hospital financial stability and workforce recruitment.
Discussion
A member asked about the CMS letter issued on September 30 that introduced a new interpretation of Section 1903 of the Social Security Act, which requires states to provide emergency Medicaid to individuals with UIS. While states currently comply with this requirement, CMS now specifies that emergency Medicaid for these individuals cannot be delivered through risk-based capitation models, such as managed care, which many states—including California—use. Instead, states must adopt non-risk payment arrangements like fee-for-service. This change takes effect on January 1, 2027, allowing time for operational adjustments. DHCS is actively reviewing the guidance to understand its implications and determine next steps.
A member thanked DHCS for its work preparing for the implementation of work requirements and highlighted automation as an important equity tool, especially for individuals who speak languages other than English. They raised a concern about populations that do not qualify for exemptions and fail to meet work requirements, noting that national research suggests this group largely consists of older women who left the workforce for caretaking responsibilities, but may not fall under explicit caretaking exemptions. The member asked if there are strategies to support this population, such as structuring or automating processes around volunteering, and emphasized the need to use data to reach them and provide coverage. DHCS acknowledged the suggestion, noted that volunteering is one of the most challenging areas to address, and expressed openness to collaborating on solutions and hearing ideas for capturing individuals who meet the law’s volunteering requirements.
A member asked whether the UIS population would be subject to work requirements despite not being federally funded and expressed concern about the challenges this would pose, suggesting potential advocacy to prevent undocumented individuals from having to comply. They also inquired about other populations in the six-month re-enrollment process, specifically American Indian and Alaska Native individuals, and whether their status verification would be automated. DHCS responded that there are no updates or changes regarding the UIS population at this time and welcomed additional feedback from advocates and stakeholders.
A member asked what the outreach campaign for work requirements would look like, noting that previous outreach to the UIS population relied on mailings and Coverage Ambassadors. DHCS responded that the next outreach campaign will be broader, exploring such options as text messaging and seeking resources for a wider media campaign.
A member strongly opposed imposing work requirements on the UIS adult population, arguing it is not legally required and would disproportionately target immigrants, potentially causing coverage loss and confusion. They asked for an update on the provider tax waiver and whether CMS has acted on California’s waiver following the July 2025 law change. DHCS responded that there are no updates on the tax waiver, noting CMS may finalize a previously issued draft rule aligned with H.R. 1, which could affect provider tax policies. Regarding the implementation plan, DHCS stated they aim to publicly release it before the end of the calendar year and are seeking feedback from advocates.
A member asked for clarification on copayments for Medicaid beneficiaries under H.R. 1, and about what factors influence decisions on defining mental health as a disability for work requirements. DHCS explained that CMS has not yet issued guidance on cost-sharing, so DHCS is developing a policy to comply with federal requirements while minimizing member impact. They noted that H.R. 1 exempts mental health and substance use disorder services from cost-sharing. Regarding mental health and disability definitions, DHCS stated that the primary levers lie with the federal administration, as CMS will issue guidance by June 2026, and encouraged advocacy at that level. In the meantime, DHCS plans to use existing data to automatically exempt individuals receiving specialty behavioral health services or certain medications from work requirements, while continuing to address nuances for new Medi-Cal applicants without diagnostic or claims data.
A member expressed concern that while behavioral health services are exempt from cost-sharing under H.R. 1, many individuals who begin treatment later require specialty care, such as rheumatology, cardiology, or other services that may not be exempt, potentially creating barriers to care. DHCS acknowledged this concern, noting that H.R. 1 sets maximum cost-sharing limits, but does not establish minimums, and guidance on minimum requirements has not yet been issued. They clarified that cost-sharing applies only to the Affordable Care Act (ACA) expansion population, not all Medi-Cal members, and emphasized that DHCS will work to implement these requirements in a way that minimizes barriers to care, drawing on prior experience with cost-sharing in Medi-Cal.
A member asked how DHCS plans to handle ex parte renewals and outreach in the context of work requirements, noting ex parte caseloads rose during unwinding, and raised concerns about data limitations and federal funding constraints. They sought guidance on balancing early education and outreach with avoiding unnecessary alarm for Medi-Cal members whose redeterminations can be automated. DHCS responded that ex parte rates have declined as eligibility waivers and flexibilities expired, and they do not expect those waivers to return; they have no current estimates for future ex parte rates, but will coordinate closely with stakeholders. DHCS aims to clearly inform members that work requirements and six month renewals are coming, stressing that many of them will not need to take action if renewed ex parte, with renewal notices confirming “no action needed.” Messaging will also emphasize keeping contact information current, reporting changes to counties, and responding to county letters to reduce confusion and anxiety.
A member reiterated concerns about expanding work requirements to the state-funded population, emphasizing it could negatively impact individuals not authorized to work and significantly increase administrative workload. They urged DHCS not to impose more frequent redeterminations on this group, noting that previous flexibilities were intentionally ended and could be reinstated. The member asked DHCS to consider restoring those flexibilities given current challenges and expressed appreciation for DHCS’ detailed work on data sources and a commitment to continued collaboration.
A member thanked DHCS for updates and praised its data mapping work to support ex parte determinations for work requirements, noting CMS is unlikely to grant extensions and urging accelerated planning with deeper stakeholder engagement across plans, counties, providers, and others. They encouraged leveraging more real time plan data to automatically exempt eligible populations, starting those technical conversations promptly, and developing robust outreach for non exempt groups (e.g., women, older women) to prevent coverage loss. They also described ongoing advocacy with the California congressional delegation, highlighting the complexity of implementing H.R. 1 across ~5 million Medi Cal members within 18 months. DHCS responded that while MCPs cannot determine eligibility or exemptions (only the state can), plans and providers are valuable partners for timely information, engagement, education, and case management. DHCS is outlining a menu of options for plan roles, will engage soon, and aims to partner broadly—including toolkits and shared messaging—to maximize retention and ensure members maintain coverage.
A member thanked DHCS for its proposal to use data to verify exemptions and raised concern about potential federal guidance prescribing artificial intelligence (AI) based data matching for work requirements. They emphasized strong opposition to using AI for disability-related determinations, noting that disability data is often incomplete and that individuals with specialty behavioral health needs may not be on Supplemental Security Income. The member commended California’s straightforward approach and encouraged partners to recognize that while AI can be helpful in some areas, its use for verifying disability exemptions poses significant risks and should be avoided.
A member asked detailed questions about how exemption verification will work for individuals with qualifying diagnoses, particularly given intermittent treatment patterns. They wanted to know whether pending or paid claims would count, how long an exemption lasts once a diagnosis is identified, whether the diagnosis follows the individual if they fall out of care, and what renewal timeframes might apply. DHCS acknowledged these are critical questions currently under review and noted that many specifics will depend on forthcoming CMS guidance. DHCS is working to balance flexibility with compliance and is engaging CMS to clarify issues, such as permanence of certain conditions versus those that may change, and how long claims-based exemptions should remain valid. No definitive answers are available yet, but DHCS confirmed these concerns are actively being addressed.
A member expressed support for leveraging MCPs as a source of information on medically complex conditions to help maintain coverage under new work requirements. They also emphasized the importance of collaboration with nonprofits and community action agencies, suggesting the creation of organizing hubs and the provision of grant funds or technical assistance to strengthen volunteer programs. These programs could help meet federal work requirement rhetoric while recognizing that Medi-Cal members already contribute significantly to their communities through caregiving and other roles. The member encouraged scaling existing volunteer initiatives and building partnerships with organizations to ensure members remain insured and offered to serve as a thought partner in developing these strategies.
2026 Expansion of Medi-Medi Plans
Lauren Gavin Solis, Chief, Office of Medicare Innovation and Integration
DHCS outlined the 2026 expansion of Medi-Medi Plans in California. Medi-Medi Plans integrate Medicare and Medi-Cal benefits for dual eligible members to improve care coordination and access. Currently available in 12 counties with 330,000 enrollees, Medi-Medi Plans will expand to 29 additional counties on January 1, 2026, reaching up to 461,000 more potential members. These plans combine Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) with MCPs to deliver comprehensive, person-centered services, including medical, behavioral health, long-term services and supports, and transportation. Enrollment is voluntary, and members benefit from continuity of care provisions and access to provider networks. The presentation also highlighted eligibility criteria, enrollment periods, new special enrollment period options for integrated care, and resources for members, providers, and stakeholders to support the transition and ensure informed participation.
Discussion
A member raised concerns about confusion and misinformation in the ecosystem of enrollment and insurance, especially with subsidies ending on November 1. They noted that targeted misinformation and fraud are affecting elders and people with disabilities, creating uncertainty about whom to trust and what information is accurate. They asked how DHCS plans to simplify communication and meet members where they are to provide easily understandable information amid the noise. DHCS acknowledged the challenge and highlighted resources on its website, including a concise fact sheet explaining Medi-Medi Plan benefits. They also recommended that individuals needing personalized assistance should contact their local Health Insurance Counseling and Advocacy Program (HICAP), which is trained on Medi-Medi Plan expansion and can offer one-on-one support to help members navigate their options.
A member thanked DHCS for the review and emphasized that the significant 2026 change for dual-eligible members has progressed somewhat under the radar amid broader Medi-Cal activity, despite being a major benefit. They noted that plans, especially local plans with existing relationships, are already reaching out to eligible and current members to support education and decision-making in the coming weeks, given open enrollment noise and potential confusion. DHCS agreed that plans are a trusted resource and highlighted its ongoing outreach through local plans to provider networks and consumer advisory boards to help disseminate clear information.
A member asked whether there are plans to evaluate consumer experience and examine demographic diversity within the older adult and dual-eligible populations. DHCS confirmed that this is a key component of the initiative’s success. Health plans will be required to submit extensive data, including Healthcare Effectiveness Data and Information Set (HEDIS) measures and other metrics developed specifically for this population, as well as complete surveys. DHCS will use these tools to monitor service delivery, ensure benefits are provided as intended, and track outcomes over time to assess improvements.
BH-CONNECT Policy and Implementation Updates: High Fidelity Wraparound Policies and More
Ivan Bhardwaj, Chief, Medi-Cal Behavioral Health Policy Division; Erika Cristo, Assistant Deputy Director, Behavioral Health; Paula Wilhelm, Deputy Director, Behavioral Health
DHCS provided an update on the BH-CONNECT initiative, which focuses on expanding EBPs, establishing Centers of Excellence (COEs) for training and fidelity monitoring, and implementing new programs, such as the Institutions for Mental Diseases (IMD) Federal Financial Participation (FFP) option for short-term mental health stays. DHCS highlighted workforce investments totaling $1.9 billion across five programs, including loan repayment, scholarships, recruitment, and residency training to address behavioral health shortages. Additional guidance is forthcoming on Activity Funds, Community Transition In-Reach Services, and alignment of the Child and Adolescent Needs and Strengths (CANS) tool. A major component is the rollout of High Fidelity Wraparound (HFW), an intensive, family-centered care model designed to keep youth with complex behavioral health needs in home and community settings. Beginning July 2026, Medi-Cal will align HFW with national standards using a new payment model. DHCS is engaging stakeholders to finalize policy.
Discussion
A member raised concerns about potential confusion between the proposed HFW bundled rate and ICC, noting that if both have separate billing codes but appear similar, clarity is needed on their fundamental differences. They cautioned against labeling the bundled rate as “HFW” if it does not fully encompass all components of that model, which requires provider certification and specific practices. The member suggested maintaining ICC as the billing code to avoid confusion and asked whether there is current thinking about how ICC and the bundled rate differ. DHCS responded that the revised proposal would allow ICC to continue as it exists today, acknowledging variation in its delivery across the state. In contrast, HFW will be more structured, with defined components, staffing, and functions forming a core bundle for every child receiving it, supplemented by other specialty mental health services. DHCS noted that allowing both services to coexist for now should help mitigate confusion and provide time to determine ICC’s future role.
A member asked about eligibility differences between ICC and HFW. DHCS responded that ICC will remain as currently defined in the published manual for the immediate future, while HFW will use decision-support criteria based on the CANS tool, with more details forthcoming in updated guidance.
A member expressed support for the initiative overall, but noted that important details still must be resolved, particularly around rate development. They emphasized the need for robust stakeholder engagement and provider involvement in discussions about rates and recommended delaying implementation until those conversations occur. DHCS acknowledged the feedback and confirmed that formal guidance will be released first in draft and then finalized toward the end of 2025 and early 2026, along with details on the rate-setting process, which they recognize stakeholders are eager to see.
A member thanked DHCS for its decision on ICC and emphasized the importance of incorporating provider input into the rate development process to ensure alignment between policy, program requirements, and reimbursement structures. They noted that the concept of bundled rates is new for county behavioral health plans under BH-CONNECT and flagged concerns about short timelines making it difficult to analyze, assess, and negotiate rates effectively. Additionally, they suggested creating a joint workgroup with DHCS, CDSS, county behavioral health, county child welfare, and providers to focus specifically on high-fidelity wraparound implementation and address related ICC nuances, given the interconnected policies. DHCS acknowledged the feedback and agreed to consider the recommendation for a collaborative workgroup.
A member expressed strong support for previous comments about the challenges providers face in understanding the differences and nuances between HFW and ICC, particularly regarding billing. They emphasized the need for more detailed guidance and endorsed the suggestion to create a workgroup to further explore these issues and provide clarity.
The member thanked DHCS for the concept paper on HFW and asked whether family peer specialists included on the team would need to be certified with the California Mental Health Services Authority (CalMHSA) specialization in parent caregiver and family support. DHCS responded that while it would be ideal for peer support specialists to be certified across Medi-Cal benefits—whether working on Assertive Community Treatment (ACT) teams or in HFW—they recognize current workforce capacity limitations and have received feedback requesting flexibility. This requirement is still under active consideration.
A member advocated for creating a pathway to ensure peer specialists on HFW teams work toward obtaining the parent, family, and caregiver support specialization, noting it requires an additional 40 hours and that scholarships have already supported two cohorts. They suggested partnering with CalMHSA and other entities to expand scholarship opportunities for this specialization. The member also asked for clarification on FFP requirements, specifically whether a county must have at least one peer specialist claim and one community health worker claim to draw down FFP funding. DHCS confirmed that under the IMD FFP program, counties must demonstrate they offer peer support specialist services and enhanced community health worker services by the time they submit their first claim for a qualifying IMD stay, verified through at least one claim for each service.
A member congratulated DHCS on launching new services and expressed excitement about the progress. They asked how stakeholders can identify counties that have not submitted IMD FFP applications, but are still opting into other evidence-based services, noting ongoing concerns about service availability varying by county. DHCS responded that they plan to keep updated lists on their website, showing counties participating in the IMD demonstration along with their facilities, and separately listing counties implementing EBPs independent of the IMD opportunity. These updates will be posted online for public access.
A member asked for clarification on the status of IMD opt-ins and the timeline for activity stipends, noting that the draft guidance indicated “no sooner than October 2025,” but final guidance had not yet been issued. DHCS responded that the timeline was pushed back after the draft release, and the final guidance will state “no sooner than January 2026,” with the goal of launching early in 2026. They explained that a third-party administrator has been selected, and next steps include finalizing the contract and setting up the activity funds portal to enable implementation in early 2026.
A member expressed appreciation for the vision of creating uniformity between DHCS and CDSS and asked whether that alignment would extend to counties, ensuring consistency between county behavioral health and child welfare departments. DHCS responded that joint guidance with CDSS is expected in November, addressing Phase 1 of CANS alignment by resolving administrative process differences across departments. Following that, Phase 2 will focus on using the same tools across both systems so CANS assessments can be shared between behavioral health and child welfare. This phased approach aims to align requirements across DHCS, CDSS, and county-level systems, including providers administering CANS.
A member thanked DHCS for close collaboration and rapid progress, noted that the Full Service Partnership (FSP) opportunity depends on short IMD stays and won’t fit every community, and requested future BH-SAC updates with a deeper breakdown of HCAI’s workforce awards. They also flagged the complexity and misalignment across EBP requirements (BHSA, EPSDT, Medi-Cal), especially for children’s EBPs, and raised concerns that some COEs lack experience with rural communities—calling for culturally appropriate adaptations and support tailored to sparsely populated areas. DHCS acknowledged the feedback, shared that they met with Health Management Associates and COEs to develop strategies for small and rural counties—both to streamline engagement and fidelity processes and to adapt models or fidelity assessments to rural realities—intending to bring concrete proposals back to counties for input. DHCS further explained that State Plan claiming requirements were set using the evidence base (e.g., ACT and Coordinated Specialty Care (CSC) require minimum in person encounters, with telehealth allowed beyond that), and emphasized openness to making service delivery feasible under current authority while exploring possible State Plan Amendments to reflect emerging evidence and rural service realities.
Thuê chuyển tiếp
G lenn Tsang, Policy Advisor, Homelessness & Housing; Katherine Barresi, RN, Chief Health Services Officer, Partnership HealthPlan of California; Amy Ellis, MFT, Adult System of Care Division Director, County of Placer Health and Human Services
DHCS provided an update on the upcoming launch of transitional rent, a mandatory Medi-Cal Community Support benefit starting January 1, 2026, for behavioral health populations of focus. Unlike other optional supports, this benefit will provide up to six months of rental assistance or temporary housing for eligible members meeting clinical, social, and transitioning criteria. DHCS released key guidance in 2025, including the Community Supports Policy Guide (April), and Transitional Rent Payment Methodology (October), with referral standards expected by year-end. DHCS emphasized strong coordination between MCPs and county behavioral health agencies to maximize resources, especially since both transitional rent and BHSA housing interventions can fund rental assistance. DHCS highlighted the results of a recent survey showing that more than half of counties plan to contract with MCPs as transitional rent providers, though concerns remain about funding capacity and sequencing of housing supports. DHCS noted they aim to address these challenges through technical assistance, policy clarification, and fostering partnerships to ensure effective implementation and resource alignment.
DHCS invited colleagues with Partnership HealthPlan of California and Placer County to discuss their efforts at the local level to expand housing and behavioral health capacity while preparing for the upcoming transitional rent benefit. They emphasized that transformative work is inherently challenging and requires deep collaboration, especially in rural areas where resources are limited. Key points included the need for counties to understand their own resources, building strong trust-based relationships with county and community partners, customizing strategies, and the importance of shared vision and engagement.
Discussion
A member asked if DHCS plans to collaborate with philanthropists to fund navigators for outreach to people experiencing homelessness, similar to efforts during ACA expansion, and whether Community Supports could fund evidence-based supported employment for individuals subject to work requirements. DHCS replied that while they are having general discussions about philanthropy’s role in H.R. 1, they encouraged stakeholders to advocate directly with philanthropists, noting ACA efforts were driven by legislative advocates. On community supported employment, DHCS stated it is not currently included in any concept papers, but acknowledged it as an interesting area for future exploration.
Bình luận của công chúng
During the public comment period, attendees were allowed to voice their concerns and offer feedback to DHCS and panel members.
A member of the public expressed strong appreciation for DHCS’ collaborative efforts and emphasized the urgency of integrated planning considering H.R. 1 and other initiatives. The speaker, a primary care physician and former CEO of a mental health and crisis care provider, highlighted the importance of breaking down silos between behavioral health services and other systems, citing programs like CANS, BH-CONNECT, and HFW as critical areas for alignment. They reaffirmed their commitment to supporting the state and stakeholders in fostering cross-system collaboration to improve care delivery.
A member of the public highlighted concerns about sustaining programs under the California Reducing Disparities Project (CRDP) as current funding ends in 2026. The intern explained that local CRDP providers are struggling to secure county-level funding despite Proposition 1 allowing for early intervention support, with many believing counties will only fund programs that qualify for Medi-Cal. This uncertainty has left Community-Defined Evidence Practices (CDEP) members feeling conflicted and unsupported, creating significant challenges in maintaining successful initiatives. The speaker warned that failure to continue these programs could lead to serious consequences for addressing racial and ethnic mental health disparities.
A member of the public expressed appreciation for DHCS’ efforts on the community planning process and related webinars, noting the importance of stakeholder engagement. The speaker, involved with the CRDP, emphasized that funding for CRDP programs ends on June 30, 2026, and participants are seeking ways to sustain their CDEPs, which have proven to be effective and cost-efficient. While they encouraged involvement in local integrated planning, they highlighted challenges for organizations that were not previously engaged in county meetings and praised Orange County’s focus groups as a positive example. The comment concluded with gratitude for DHCS’ continued support and information-sharing to help community stakeholders participate effectively.
