Medi-Cal Mental Health Waiver Approved

Federal officials last week approved California’s specialty mental health services waiver for the next five years, a big step in the state’s effort to combine mental and physical health services.

“I am thrilled to announce … that the Centers for Medicare and Medicaid Services approved our waiver renewal request for Specialty Mental Health Services,” Jennifer Kent, director of the Department of Health Care Services, wrote in a June 26 announcement to stakeholders.  

“Not only did we get this approval, but CMS, for the first time, signed off on a five-year renewal term,” Kent said. “That’s an enormous accomplishment and an important step toward opening the door to critically needed mental health care — including psychotherapy, psychiatric consultation, lab tests, and medication — to our members all across California.”

The new waiver extends to June 30, 2020, and targets those with serious mental illness. The agreement should further the state’s effort to integrate mental health services with delivery of other care, Kent said. The state’s Department of Mental Health was folded into the larger DHCS agency in 2011.

“The waiver … will also allow us to improve program integrity, monitoring and compliance in important areas, and we will continue improving care coordination between physical and mental health care services,” Kent said in an email response to questions. 

“We believe that better monitoring and quality oversight will allow all interested parties, including advocates, policymakers and the federal government, to see the types and levels of service provided in our county delivery system,” she said. “Quality measurement is an important component to ensure we are collectively serving these populations to the greatest extent possible.”

Kent said word of the waiver approval reached DHCS officials June 24, and she made the official announcement two days later. Usually, this type of waiver is only approved on a two-year cycle, but under the Affordable Care Act, states have been allowed to request five-year waivers.

California is the first state to be approved for the longer five-year period, Kent said. 

The first shift of the state’s mental health program to managed care started in 1995 with a consolidation of Medi-Cal psychiatric inpatient hospital services.

“The renewal of the Specialty Mental Health Services waiver is an important step in California’s effort to deliver important specialty mental health services to Californians in need,” Kent said. “We will use this five-year extension of the SMHS waiver to continue ensuring that rehabilitative mental health services, psychiatric inpatient hospital and professional services, targeted case management, and EPSDT (Early and Periodic Screening, Diagnosis and Treatment) supplemental specialty mental health services continue to be available.”

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Capitol Desk Medi-Cal Mental Health