State Medi-Cal Specialty Mental Health Services Program

A large majority of consumers who utilize California's county mental health services are enrolled in Medicaid. Medicaid is a state-administered federal entitlement program (Medi-Cal), and each state sets its own guidelines regarding eligibility and services within the parameters of the federal law and regulations.

Unlike most other states, California's Medi-Cal specialty mental health program is entirely managed by local government. Medi-Cal beneficiaries who are living with a severe and/or persistent mental illness are eligible for services under California's Medi-Cal Specialty Mental Health Services program, which is administered by the state Department of Mental Health (DMH). The Department of Mental Health, in turn, contracts with county mental health authorities to provide mental health services to this population.

Legislative Briefing Packet: Fall 2009

• Summary of Key 2009-2010 Budget Items for Community Mental Health (November 2009)
  (PDF 64 KB)
• California’s Community Mental Health System (November 2009) (PDF 201 KB)
• Major Sources of Funding for California’s Community Mental Health System (November 2009)
  (PDF 52 KB)
• Contact Information (PDF 195 KB)

Medi-Cal Waiver 1115 Workgroup Meeting Documents

March 4, 2010

• 1115 Waiver Workgroup Meeting Notes for 2/23/10 (Posted: March 1, 2010) (PDF 46 KB)
• California 1115 Waiver Pilot for MH/SU Integration with Healthcare Pilot Project Abstract COHS (Posted: March 3, 2010) (PDF 20 KB) 
• California 1115 Waiver Pilot for MH/SU Integration with Healthcare Pilot Project Abstract Example Coverage Initiative (Posted: March 3, 2010)  (PDF 20 KB)
• California 1115 Waiver Pilot for MH/SU Integration with Healthcare Pilot Project Abstract V 22 pln county (Posted: March 3, 2010) (PDF 20 KB)
• Recommendations for California’s New Medicaid 1115 Waiver: Pilot Projects to Integrate Physical and Behavioral Health Care for Persons with Serious Mental Illness VOLUME 1 of 2 (Posted: March 3, 2010)  (PDF 176 KB)
• DHCS BHI Technical Workgroup (Link)

February 23, 2010

• 1115 Waiver Work Group Meeting Agenda & Notes from 2/1/10 meeting (Posted: February 19, 2010) (MS Word)
• Waiver Pilot Abstract Example (Posted: February 19, 2010) (PDF KB)
• Letter from Assemblyman Jim Beall (Posted: February 19, 2010) (PDF 606 KB) 
• DHCS BHI 1115 Waiver Workgroup Material for February 24, 2010 BHI Meeting (Link) 
   

February 1, 2010

• Agenda for Medi-Cal Waiver 1115 Work Group Meeting (Posted: January 29, 2010) (PDF 30 KB)
• California Healthcare Foundation Overview of Delivery Models (Posted: January 29, 2010) (PDF 45 KB)
• County Waiver Status (Posted: January 29, 2010) (PDF 32 KB) 
• DHCS Behavioral Health Integration Technical Workgroup Established (Posted:  January 27, 2010)
  
  • Behavioral Health Integration Technical Workgroup Charter (PDF 45 KB)
  • Behavioral Health Integration Technical Workgroup Draft Meeting Schedule and Agendas (PDF 21 KB)
  • Behavioral Health Integration Technical Workgroup Membership (January 26, 2010) (PDF 44 KB)

January 18, 2010

• CCCMHA 1115 Waiver Recommendations (Posted: January 19, 2010) (PDF 175 KB)
• State Mental Health Spending: Implications for Healthcare Reform (D. Jarvis) (PDF 322 KB) 

January 15, 2010

• 1/5/2010- Behavioral Health, the Changing Healthcare Landscape, and California 1115 Waiver Opportunities Webinar Powerpoint Presentation (Posted: January 14, 2010) (PPT 4.7 MB)
• 1/5/2010- CiMH Webinar 1115 Waiver Presentation Q&A (Posted: January 14, 2010) (PDF 130 KB)
• 1115 Waiver Group Powerpoint, Recommendations To date (Posted: January 15, 2010) (Powerpoint 53 KB) 

 Previous Meeting Materials:

• Medi-Cal Waiver 1115 Workgroup Agenda (Posted: December 1, 2009) (PDF 27 KB) 
• Four Quadrant Model, National Council for Community Behavorial Healthcare (Posted: November 30, 2009) (PDF 123 KB) 
• Medi-Cal Managed Care Specialty Mental Health Policy Issues (Posted: December 1, 2009)
  (MS Word KB)
• Mental Health White Paper for Discussion (Posted: December 1, 2009) (PDF KB)
• Designing a Person Centered Healthcare Home for the Population with Serious Mental Illnesses (Powerpoint) (Posted: December 8, 2009) (PDF KB)
• 091201 Mtg Notes (Posted:December 15, 2009) (PDF KB)
• 091208 Mtg Notes (Posted: December 15, 2009) (PDF KB)
• 0912 Medi-Cal Waiver Group Recommendations Powerpoint for 12/16/09 (PDF KB)
• 091216 Medi-Cal Waiver Workgroup Notes Finance Options (Posted: December 17, 2009)
  (PDF 16 KB)

Background Material

• DHCS Section 1115 Waiver Concept Paper (Posted: October 20, 2009) (PDF 85 KB)
• California Association of Public Hospitals and Health Systems Waiver Recommendation
  (Posted: October, 16, 2009) (PDF 101 KB)
  • Cover Letter:  CAPH Waiver Recommendation (Posted: October, 16, 2009) (PDF 31 KB)
• CMHDA Brief Response to DHCS Concept Paper 1115 Waiver (October 30, 2009) (PDF 45 KB)
• Low Income Consumer Advocates' Recommendations for California's Next 1115 Waiver  (Link)
• CADPAAC: 1115 Waiver Concepts (Posted: November 30, 2009) (PDF KB)
• CPCA: Health Care Homes: Solution to Achieving Better Care Coordination and Long Term Cost Containment in Medi-Cal Waiver (Posted: November 30, 2009) (PDF KB)
• California Hospital Association Comments Waiver (Posted: December 2, 2009) (PDF KB)
• Measurement of Health Status SMI NASMHPD (Posted: December 8, 2009) (PDF 689 KB)
• Connected Care Data Template (Posted: December 8, 2009)  ( PDF 118 KB)
• Interim Evaluation of Health Care Coverage Initiative in California (August 2009) (Link) (Posted: December 8, 2009)
• State Options For Improving Health And Health System Outcomes For Frequent Users Of Health Services  (Posted: December 8, 2009) (PDF 189 KB)
• Establishing Accountable Physical/Behavioral Health Care Homes: Pennsylvania’s Innovations Pilots
• Connected Care Program of Pennsylvania Webinar (Link) (Posted: December 8, 2009)
• Maryland Health Choice 1115 (Link) (Posted: December 8, 2009)
• Maryland Rare and Expensive Case Management (REM) Program (Link) (Posted: December 8, 2009)
• Integrating Behavioral Health Under Medicaid (Center for Health Care Strategies) (Link) (Posted: December 8, 2009)
• Purchasing Strategies to Improve Care Management for Complex Populations: A National Scan of State Purchasers (Center for Health Care Strategies) (Link) (Posted: December 8, 2009)
• Healthcare Payment Reform and Behavioral Health Safety Net, National Council for Community Behavioral Health System (Posted: December 8, 2009 (PDF KB)
• Medi-Cal Waivers (March 2000) - California Healthcare Foundation
• Cost Studies at Northern California Kaiser Permanente (C. Weisner Powerpoint) (Posted: February 4, 2010) (PDF 640 KB) 

 Medi-Cal 1115 Waiver Documents 

• CMHDA Brief Response to DHCS Concept Paper 1115 Waiver (October 30, 2009) (PDF 45 KB)
• DHCS Director's Message (Posted: October 20, 2009) (PDF 12 KB)
• DHCS Section 1115 Waiver Concept Paper (Posted: October 20, 2009) (PDF 85 KB)
• DHCS Section 1115 Waiver Renewal Stakeholder Process (Posted: October 20, 2009) (PDF 18 KB)
• CMHDA Principles for DHCS 1115 Demonstration Waiver (October 16, 2009) (PDF 33 KB)
• Governor's Letter to Congressional Delegation re: Medicaid Rules (April 8, 2008) (PDF 66 KB)
• DCHS Letter: Confidentially Policies Governing the Medi-Cal Eligibility Date System (February 5, 2008) (PDF 105 KB)

Agencies Links

• State Department of Mental Health
• DMH: Medi-Cal Specialty Mental Health

For More Information:

• Patricia Ryan, MPA – Executive Director
  Contact for state budget issues and association matters.
  pryan@cmhda.org
• Don Kingdon, PhD – Deputy Director & Small Counties Liaison
  Contact for Medi-Cal and other regulatory issues
  dkingdon@cmhda.org
• Kirsten Barlow – Associate Director, Legislation & Public Policy
  Contact for state legislation and public policy issues
  kbarlow@cmhda.org