The Department of Health Care Services (DHCS) administers California’s Medicaid (Medi-Cal) program. The Medi-Cal Specialty Mental Health Services (SMHS) program operates under the authority of a Section 1915(b) waiver approved by the Centers for Medicare & Medicaid Services (CMS), alongside the State’s other Medi-Cal delivery systems: Medi-Cal managed care, dental managed care, and the Drug Medi-Cal Organized Delivery System (DMC-ODS). DHCS received approval on December 29, 2021 from CMS for the CalAIM Section 1915(b) waiver, effective through December 31, 2026.​​  

As the single state Medicaid agency, DHCS is responsible for administering the Medi-Cal SMHS waiver program, which provides SMHS to Medi-Cal beneficiaries through county mental health plans (MHPs). The MHPs are required to provide or arrange for the provision of SMHS to beneficiaries in their counties that meet medical necessity criteria, consistent with the beneficiaries’ mental health treatment needs and goals.​​