DHCS releases 2021 timeline for CalAIM initiative

The California Department of Health Care Services (DHCS) offered stakeholders a timeline of 2021 “implementation milestones” to support the CalAIM initiative during a relaunching webinar last week.

The agency released an updated CalAIM proposal last month, introducing key changes following stakeholder feedback and adjustments due to the COVID-19 pandemic. DHCS’s release of the updated initiative is the latest step in the department’s effort to implement broad program, delivery system, and payment reform for the Medi-Cal program.

 

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During the first few months of 2021, DHCS will release a handful of draft documents related to the Enhanced Care Management (ECM) and In Lieu of Services (ILOS) components of CalAIM. As part of Medi-Cal reform, DHCS is proposing an enhanced care management benefit that builds off of the current Health Homes Program and Whole Person Care Pilots to provide comprehensive care for high-need beneficiaries. The ILOS component of CalAIM refers to flexible, wraparound services that managed care plans will integrate into their population health strategies.

Drafts of the ECM/ILOS Model of Care, transition plans, and managed care plan contract language are expected in mid to late February. During this time, DHCS will also begin its technical assistance efforts.

Aaron Toyama, Senior Advisor at DHCS, says there will be a comment period on these documents with final drafts expected to be released in March of this year.

During these months, the initiation of the public comment process for the state’s Section 1115 and 1915(b) waiver renewals will begin.

Toyama also says the Managed Long-Term Services and Supports and Duals Integration workgroup will begin its work with its first meeting on Thursday, February 4.

 

Image: California Department of Health Care Services

 

Between April and June of 2021, DHCS will release draft Managed Care Plan (MCP) rates for Enhanced Care Management and will offer in Lieu of Services pricing guidance. DHCS will also form county oversight and monitoring workgroups and will develop auditing tools for California Children’s Services (CCS) and Child Health and Disability Prevention (CHDP) programs.

The last half of 2021 will see MCPs submit “readiness documents” for ECM/ILOS for review and approval by DHCS.

“This is where we are really getting ready for the big launches in 2022,” said Toyama.

This will also be the time when the stakeholder process begins for the county inmate pre-release application process. This CalAIM component proposes mandating a Medi-Cal pre-release application process for county inmates to ensure they receive timely access to services upon release from incarceration. According to a DHCS presentation, the initiative also:

“Proposes mandating that jails and county juvenile facilities implement a process for facilitated referral and linkage from county institution release to county specialty mental health, Drug Medi-Cal, DMC-ODS, and Medi-Cal managed care plans when the inmate was receiving behavioral health services while incarcerated, to allow for continuation of behavioral health treatment in the community.”

DHCS will also publish an updated process for monitoring and reporting County Performance Standards.

DHCS concluded its webinar with a broad outline of key milestones for 2022, a year that Toyama describes as a big and exciting year:

 

Image: California Department of Health Care Services