Michelle Baass

The Systems and Medicaid Committee meeting focused extensively on the CalAIM Payment Reform initiative, which was scheduled to go live on July 1, 2023. Discussions included the transition from cost-based reimbursement to fee-for-service payments, the shift to Intergovernmental Transfers (IGTs) for financing, and the transition from HCPCS II to CPT coding. Presentations were provided by the Department of Health Care Services (DHCS), the County Behavioral Health Directors Association (CBHDA), and the California Council of Community Behavioral Health Agencies (CBHA) to cover state, county, and provider perspectives on this reform. Other key discussions involved updates on Short-Term Residential Treatment Programs (STRTPs), challenges related to IMD determinations affecting STRTP capacity, an overview of the Children and Youth Behavioral Health Initiative (CYBHI), and updates on behavioral health policy developments including the Crisis Care Continuum Plan.

The Systems and Medicaid Committee meeting focused on several key items related to the implementation of Senate Bill 43, which amends the Lanterman-Petris-Short Act to broaden the definition of "grave disability." Discussions included an overview of Senate Bill 43 from the County Behavioral Health Directors Association (CBHDA) perspective and a presentation from Sutter Health on hospital implementation challenges, including workforce adjustments and monitoring involuntary holds. The committee also heard the county perspective from San Francisco regarding local implementation. Other major topics included an overview of the CalAIM Concept Paper for waiver renewals and a discussion and action item regarding the committee's completed activities for the Council's 2025 Year-End Report. The meeting concluded with an action item for the election of the 2026 Committee Chair-Elect.

The Systems and Medicaid Committee meeting included several key discussions and presentations focused on behavioral health systems. The agenda included a review and approval of the 2024-2025 Work Plan, which guides committee activities related to influencing policy changes for the behavioral health system, monitoring CalAIM implementation, and reviewing the BH-CONNECT Demonstration Waiver. Presentations covered an overview of the Older Adult System of Care from the perspective of the CA Department of Aging and Sacramento County Department of Health Services, followed by a presentation from El Hogar, Inc. regarding their Older Adult Programs. The committee also received updates from the CBHPC Workgroups, including Reducing Disparities, Children and Youth, and Substance Use Disorder, as well as updates on current behavioral health policies concerning CalAIM implementation feedback, payment reform, and the BH-CONNECT initiative.

The Systems and Medicaid Committee meeting agenda covered several key areas related to Substance Use Disorder (SUD) services within the Behavioral Health Services Act (BHSA) Full-Service Partnerships (FSP). Discussion topics included an overview of SUD services in FSP programs by the Department of Health Care Services, presenting the policy and provider perspective on implementation challenges, and detailing the county perspective from Orange County Health Care Agency regarding local implications. The committee also addressed behavioral health transformation initiatives, identified priority areas for advocacy concerning the BHSA (such as FSP eligibility and housing continuum), and reviewed the October 2024 draft meeting minutes.

The Systems and Medicaid Committee meeting included reviews and updates on several initiatives. Key discussions involved the review and update of the SMC Work Plan and the CBHPC Year-End Report. Significant time was dedicated to presentations concerning the CalAIM Documentation Redesign Initiative, which streamlines behavioral health documentation requirements, and an overview of physical and digital behavioral health platforms for children and youth, specifically the Scout and Allcove Programs. Additionally, the committee received updates on CBHPC Workgroups, behavioral health policy updates, and the nomination process for the 2024 SMC Chair-Elect. Discussions regarding CalAIM payment reform implementation, including cash flow concerns, the transition from CPE to IGT financing, and the adoption of CPT codes, were also central to the meeting, featuring input from the Department of Health Care Services (DHCS), the County Behavioral Health Directors Association (CBHDA), and provider groups.