Medi-Cal continues to be a critical access point for health care and home and community-based services (HCBS) for older adults and people with disabilities.
As these populations grow and their needs change, it’s imperative that Medi-Cal evolve to remain responsive. Through the California Advancing and Innovating Medi-Cal (CalAIM) program, the California Department of Health Care Services (DHCS) embarked on efforts to make Medi-Cal more person-centered, equitable, and coordinated. DHCS utilized federal 1115 Medicaid Waiver Authority through the Centers for Medicare and Medicaid Services (CMS) to implement CalAIM over a five year period. As the 1115 waiver expires at the end of this year, DHCS published their renewal application for public comment from February 10, 2025 to March 12, 2025.
The application largely focuses on continuing CalAIM initiatives; however, it does include two new proposals related to HCBS. The SCAN Foundation (TSF) submitted a comment letter that acknowledges the state’s commitment to improving health care and HCBS access while offering recommendations to strengthen proposals.
Key themes addressed in the letter include:
- Implications of the design of the proposed BridgeCare pilots, an opt-in program for local entities (regions/counties) to provide HCBS to older adults just over income eligibility for Medi-Cal (near duals)
- Recommended services to be included in the BridgeCare pilots discretionary services package
- Consideration for an advisory committee to advise on the transition of the Community Based Adult Services program from 1115 waiver authority to 1915i waiver authority
The letter is intended to inform DHCS’ final renewal application to be submitted later this year.
Read the letter here.