CHA News Article

DHCS Releases Updated Health Homes for Patients with Complex Needs Concept Paper
Will accept stakeholder feedback on proposal through May 6

The Department of Health Care Services (DHCS) has released its Health Homes for Patients with Complex Needs California Concept Paper Version 2.0, authorized under Section 2703 of the Affordable Care Act. The paper is an update of the initial DHCS proposal, released in November 2014. Section 2703 allows states to create Medicaid health homes to coordinate the full range of physical health, behavioral health and community-based long-term services and supports required by Medicaid members with chronic conditions. Federal matching funds are available for two years at 90 percent. If the plan is implemented in California, The California Endowment has committed to funding the remaining 10 percent (up to $25 million per year) required for the additional services for the same two-year period. AB 361 (Chapter 642, Statutes of 2013) authorized California to submit a Section 2703 state plan amendment to the Centers for Medicare & Medicaid Services (CMS), subject to several conditions, including cost neutrality and an evaluation after the first two years.

DHCS guiding principles of this initiative are to improve care coordination; integrate palliative care into primary care delivery; strengthen community linkages with health homes; strengthen team-based care, including use of community health workers, promotores and other frontline workers; improve the health outcomes of individuals with high-risk chronic diseases; and avoid reportable net cost within two years.

In its revised concept paper, DHCS has outlined its thinking on the following key components of the initiative: eligibility criteria (including the target population, acuity and eligible criteria selection data analysis); health home services (comprehensive care management, care coordination and health promotion, comprehensive transitional care, individual and family support services, referral to community and social supports, and use of health information technology and exchange to link services); the health home infrastructure; Medi-Cal managed care plan requirements; community-based care management entity requirements; beneficiary assignment; additional program elements and timeline; current status of implementation; program evaluation; and stakeholder engagement prior to the state’s submission of its State Plan Amendment (SPA). DHCS anticipates submitting its SPA to CMS in August.

DHCS requests that stakeholders submit comments and feedback to by May 6. More information is available in the attached DHCS concept paper. For more information on the Health Homes for Patients with Complex Needs initiative, visit