CHA News Article

DHCS Releases Whole Person Care Pilot Program Application
Stakeholder comments due April 18

The California Department of Health Care Services (DHCS) has released the attached draft Whole Person Care (WPC) pilot program application and selection criteria for stakeholder review. The application reflects the requirements described in the Medi-Cal 2020 Special Terms and Conditions, which include identifying the target population; a description of the WPC pilot structure and the needs of the target population; services that will be provided and the interventions that will be applied; and the funding request. Comments on the draft WPC pilot application and selection criteria are due to DHCS on April 18 and should be submitted to DHCS intends to release the final WPC pilot application on May 16.

The WPC pilot program is an initiative under California’s section 1115(a) demonstration waiver, titled “California’s Medi-Cal 2020 Demonstration.” The waiver renewal — effective Dec. 30, 2015, through Dec. 31, 2020 — includes $6.2 billion of initial federal funding to support the state’s Medi-Cal program and its health care coverage of more than 13 million individuals. WPC pilots will provide an option to a county, a city and county, a health or hospital authority, or a consortium of any of the above entities serving a region consisting of more than one county or  health authority, to receive support to integrate care for a particularly vulnerable group of Medi-Cal beneficiaries who have been identified as high users of multiple systems and continue to have poor health outcomes.

Through collaborative leadership and systematic coordination among public and private entities, WPC pilot entities will identify target populations, share data between systems, coordinate care in real time, and evaluate individual and population progress — all with the goal of providing comprehensive coordinated care for the beneficiary, resulting in better health outcomes. WPC pilots may also choose to expand access to supportive housing options for these high-risk populations. The waiver renewal authorizes up to $1.5 billion in federal funding over the five years; WPC pilot lead entities will provide the non-federal share.

Additional information on the WPC pilots is available on the DHCS website; DHCS issued updated frequently asked questions April 13.