CalAIM funding requested by DHCS in the legislature

The California Senate Budget and Fiscal Review Subcommittee on Health and Human Services heard budget proposals from the Department of Health Care Services (DHCS) on the California Advancing and Innovating in Medi-Cal (CalAIM) initiative on Friday.

 

 

The DHCS requested an expenditure authority of $1.1 billion for local assistance costs. This $1.1 billion would be broken up into $520.8 million in General Fund dollars and $552.9 million in federal dollars. They also requested an expenditure authority of $52.1 million from 2021-23, they also requested staffing positions for these and future years. The DHCS said that if approved these positions and resources would support the state operations costs of implementing the initiative.

 

Image Courtesy of California Senate Budget Subcommittee on Health and Human Services

 

The $1.1 billion dollars requested by DHCS for local assistance costs would support:

  • $187.5 million to support the new enhanced care management benefit in Medi-Cal managed care plans that would begin Jan. 1, 2022.
  • $47.9 million to support in-lieu-of services benefits adopted by Medi-Cal managed care plans that would begin Jan. 1, 2022.
  • $300 million to fund incentives for managed care plans to invest in voluntary in-lieu-of services programs and partner with community-based organizations and providers.
  • $401.6 million to support transitions of populations between the fee-for-service and managed care delivery systems.
  • $113.5 million for enhanced reimbursements for dental services that were previously included in the Dental Transformation Initiative component of Medi-Cal 2020.
  • $21.8 million for the behavioral health quality improvement program.

The money requested by the DHCS for state operations includes:

  • In 2021-22:
    • 33 positions
    • An expenditure authority of $23.9 million, which is split between $11 million in General Fund dollars and $12.8 million in federal funds.
  • In 2022-23:
    • 40 positions
    • An expenditure authority of $28.2 million, which is split between $13.2 million in General Fund dollars and $15 million in federal funds.
  • In 2023-24, they requested an expenditure authority of $25.2 million, which is split into $12 million in General Fund dollars and 13.2 million in federal funds.
  • In 2024-25, they requested an expenditure authority of $23.9 million, which is split between $11.6 million in General Fund dollars and $12.3 million in federal funds.
  • In 2025-26, they requested $20.3 million, which is split into $9.8 million from the General Fund and $10.5 million from federal funds.

In addition to the staffing resources requested by the DHCS, they requested an expenditure authority of $5.9 million in 2021-22 and $7.8 million in 2022-23 to support contract resources for the CalAIM initiative.

In Jan. 2021, DHCS released their updated CalAIM proposal. This proposal would resume the efforts delayed by the COVID-19 pandemic to reform the delivery of health care services in the Medi-Cal program. They have moved to transition many of its existing programs into managed care benefits under a new 1915(b) waiver, maintain some programs under the previous 1115 waiver and make other changes through amendments to the state plan. 

They also announced an updated timeline for this initiative in a relaunching webinar in late January.