California has a generational opportunity to reform our state’s troubled Medicaid program. In October 2019 the Department of Health Care Services (DHCS) presented a reform agenda through the CalAIM proposal. We released our analysis of the proposal in November 2019.

An astonishing amount of progress has been made in a short period of time, but current events jeopardize that momentum. COVID-19 and demands for racial injustice underscore the urgent need to advance CalAIM’s children’s behavioral health reform effort.

Issue Briefs

June 2020: The Urgent Need to Advance CalAIM’s Children’s Behavioral Health Reform Effort

This brief and the accompanying presentation from CMHACY 2020 outline the path forward to realize the behavioral health sector reforms that will enable California to better serve vulnerable children and families.

DHCS Updates

June 2020: DHCS Signals Intent to Reform Medical Necessity and Expand Access

On June 19 the California Department of Health Care Services (DHCS) published a new “game-changing” Family Therapy Benefit Guide. These guidelines are the most fundamental reform to medical necessity criteria in the history of the state’s mental health system. They allow for Z codes (psychosocial concerns) and the criteria are trauma-informed and relevant to our state’s efforts to respond to the impact of adverse childhood experiences on the social and emotional health of children. These changes were an essential recommendation that the California Children’s Trust and its partners made during the CalAIM process. Read.

Response Letters to DHCS: December 2019 – March 2020

With our reform partners, we have been carefully monitoring updates to the CalAIM proposal and submitting written feedback to DHCS. Following are our response letters.

CCT’s Analysis of CalAIM: November 2019

CalAIM proposes real and substantive changes for specialty mental health. It is far and away the most ambitious and courageous action by DHCS on mental health in more than 20 years. However, the proposal does not do enough to center racial justice, or properly or effectively clarify how it will promote or incentivize delivery system reform and child-serving system integration and expansion. Read our analysis for more detail.