DHCS Stakeholder News Update - May 6, 2022
Dear Stakeholders,
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs, as well as guidance related to the COVID-19 public health emergency.
DHCS Executive Staff Change
On May 31, Kelly Pfeifer, Deputy Director for Behavioral Health, will retire from state service to pursue other endeavors. For nearly three years, Kelly has led the development and implementation of transformational, historic mental health and substance use disorder services programs and initiatives, including in the California Advancing and Innovating Medi-Cal (CalAIM) initiative, Behavioral Health Continuum Infrastructure Program (BHCIP), and Behavioral Health Modernization project.
Tyler Sadwith, Assistant Deputy Director for Behavioral Health, will serve as Acting Deputy Director upon Kelly's departure.
BHCIP and Community Care Expansion Program Update
The 2021-22 California State Budget provided once-in-a-generation investments in infrastructure funding alongside significant new state and federal resources to address homelessness, support health care delivery reform, and strengthen the social safety net. Together these commitments will address historic gaps in the behavioral health continuum to meet growing demand for services and supports. Infrastructure resources, led by DHCS and the California Department of Social Services, will ensure care can be provided in the least-restrictive settings by creating a wide range of options, including outpatient alternatives, urgent care, peer respite, wellness centers, social rehabilitation models, and licensed community care facilities. A variety of care placements can provide a vital off-ramp from intensive behavioral health service settings and transition the most vulnerable Californians to community living, as well as provide housing options for older adults and people with disabilities. For more information about these programs, please visit the
BHCIP webpage.
Medi-Cal Rx 180-Day Transition Policy
When Medi-Cal Rx launched, a 180-day transition policy was implemented to reduce the impact of the transition on Medi-Cal beneficiaries by extending their previously approved prescriptions, with or without previously approved prior authorizations (PA), through July 1, 2022. Medi-Cal Rx will continue to use historical PA and claims data for the transition policy beyond July 1, 2022. DHCS and Magellan Medicaid Administration are evaluating the appropriate time to terminate this transition policy. Detailed information will be provided in the coming weeks. Stakeholders will be given 90 days' notice prior to the end of the 180-day transition policy.
Population Health Management (PHM) Vendor Contract
On May 9, DHCS will release an Invitation for Proposal (IFP) for a
PHM Service vendor, as part of the
CalAIM initiative. DHCS intends to award the resulting contract by July 2022. This procurement solicits applications for the development, operation, and eventual turnover to DHCS of the PHM Service.
The PHM Service seeks to transform the whole-person delivery of care to Medi-Cal beneficiaries, while managing risk and addressing gaps in care and social drivers of health. The PHM Service will support a beneficiary-centric view for business partners (state departments and agencies, local county partners, etc.); health care delivery partners (hospitals, skilled nursing facilities, etc.); and managed care organizations (county Drug Medi-Cal, Medicare Advantage, etc.) with access to clinical and programmatic data that can be used to help improve quality of care.
DHCS anticipates that implementation of the PHM Service will contribute to the overall CalAIM goal of improving beneficiaries' quality of life and health outcomes, aligned with Medi-Cal initiatives outlined in Assembly Bill 133 (Chapter 143, Statutes of 2021). More information about the PHM Service is available in the draft
PHM Program and Service Roadmap. For questions or comments, please email
CalAIM@dhcs.ca.gov.
Published COVID-19 Information
Additional updates will be posted on the
DHCS COVID-19 Response page.
