WHAT YOU NEED TO KNOW: California’s strong partnership with the Biden-Harris Administration is helping advance the state’s vision of a Healthy California for All.
SACRAMENTO –Following yesterday’s State of the Union Address, California Health and Human Services Agency (CalHHS) Secretary Dr. Mark Ghaly is highlighting how the strong partnership between the state and the Biden-Harris Administration is helping us ensure California delivers programs that are person-centered, equity-focused, and data-driven in order to help deliver on our vision of a Healthy California for All.
“The Biden-Harris Administration has been and continues to be a strong partner as we work collectively to advance our vision of a Healthy California for All,” said Dr. Mark Ghaly, Secretary of the California Health & Human Services Agency. “This partnership has led to the approval of waivers, flexibilities and programs that support Californians with a focus on the most vulnerable among us.”
HOW PARTNERSHIP BENEFITS CALIFORNIANS: Through California’s partnership with the Biden-Harris Administration, the state has been able to take action to lift up our most vulnerable neighbors when they needed it the most. Example of waivers and flexibilities approved by the Federal government include:
SUPPORTING MEDI-CAL MEMBERS BY KEEPING THEM COVERED AND IMPROVING QUALITY AND ACCESS:
- Approvals of waivers and flexibilities as part of the Medicaid (Medi-Cal) eligibility redetermination process. The Department of Health Care Services (DHCS) applied and received federal approval for fourteen different federal waivers, more than any other state. This has helped more Californians keep their coverage.
- Approval of CalAIM waiver in Federal Medicaid program:
- CalAIM 1115 Demonstration & 1915(b) Waiver: California received federal authority necessary to implement CalAIM, a framework that encompasses broad-based delivery system, program, and payment reform across the Medi-Cal program.
- Enhanced Care Management (ECM) addresses clinical and non-clinical needs of the highest-need Medi-Cal enrollees through coordination of health and health-related services.
- Community Supports are statewide services that provide medically appropriate alternatives to traditional medical services and settings. These include assistance with housing supports, food insecurity, caregiver respite, and transitioning from nursing home care back to the community.
- Justice-Involved Initiative. In January 2023, the Centers for Medicare & Medicaid Services (CMS) approved a waiver, making California the first state in the nation approved to offer a targeted set of Medicaid services to youth and eligible adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release.
- Approval of the initial Managed Care Organization (MCO) Tax in Federal Medicaid program. California received federal approval from the CMS for its MCO tax federal waiver application. The MCO tax proposal supports Medi-Cal investments that will help secure access, quality, and equity in the Medi-Cal program, including increasing provider rates to at least 87.5% of Medicare rates for certain providers.
- Approval of Home and Community-Based Services (HCBS) spending plan in the Federal Medicaid program, providing $3 billion in one-time enhanced federal funding to support programs that serve the most vulnerable Californians, including the aging, disabled, homeless, and those with severe behavioral health needs.
HOUSING AND OTHER SUPPORTIVE SERVICES:
- Support of Project Roomkey, a groundbreaking, local-led and state-supported initiative that provided non-congregate shelter options, such as hotels and motels, for people experiencing homelessness, to protect human life, and to minimize strain on health care system capacity during the COVID-19 pandemic.
- Approval of waivers in support of the Guaranteed Income Pilot Program, including CalFresh, Medi-Cal, and CalWORKs, which allow pilot participants to accept guaranteed income without the loss of key existing safety net resources. The pilot program will provide unconditional and recurring cash payments intended to support the basic needs of the recipients.
- Approval of an application to participate in the Housing and Services Partnership Accelerator, an initiative that looks to bridge system silos to address the needs of our neighbors who have complex health needs and are experiencing or are at-risk of homelessness.
- Approval of application to participate in the All INside Collaborative. ALL INside is a first-of-its kind initiative to address unsheltered homelessness across the country
PANDEMIC SUPPORT:
- During the COVID-19 pandemic, many families who participate in programs that provide services and supports faced challenges such as loss of income, difficulty accessing program offices, limited food availability and increased health risk. To address these issues, the Federal Government approved program waivers and flexibilities to help Californians get and keepthese crucial safety-net benefits including Federal Medicaid (Medi-Cal in California) program, Supplemental Nutrition Assistant Program (SNAP, CalFresh in California) program, Temporary Assistance for Needy Families (TANF, CalWORKS in California) program, and Women, Infants, and Children (WIC) program.
ENSURING FAMILIES HAVE ACCESS TO NUTRITIOUS FOOD:
- Approval of benefit replacements and to operate the Federal Disaster SNAP program(CalFresh) to ensure access to food during various declared disasters and emergencies.
- Approval of updated methodologyto increase nutrition benefits in the Federal SNAP (CalFresh) program to better reflect the rising cost of food.
- Approval of the Pandemic-Electronic Benefits Transfer programwhich provided additional food benefits to children eligible for free or reduced-price school meals, but who could not access those school meals because of pandemic-related school closures.
- Approval of ongoing waivers and flexibilities to ensure that CalFresh reaches those in need, like older adults and people with disabilities.
- Approval of waivers that allow flexibilities during emergencies for continued operation of the Child and Adult Care Food Program, which provides nutritious food to infants, children, and adults.
- Approvals of waivers and flexibilities during the infant formula shortages in 2022 and 2023, which occurred due to a major recall and supply shortage of infant formula. These waivers and flexibilities included providing WIC families options to purchase any brand, size, or type of infant formula that was available at a WIC-authorized grocery store when their regular WIC formula was unavailable. As a part of these waivers and flexibilities, the USDA authorized the issuance of certain infant formulas imported under the United States Food and Drug Administration’s Infant Formula Enforcement Discretion Policy.
LOW INCOME HOUSEHOLD WATER ASSISTANCE PROGRAM:
- Approved flexibility to extend the program deadline for low-income household water bill assistance by six months, affording over 25,000 low-income Californians the opportunity to receive financial assistance to help pay their water and sewer utility bills. Under the Low-Income Household Water Assistance Program (LIHWAP), administered in California by the Department of Community Services and Development (CSD) through community partners, over 78,000 low-income households have received help with their water bills. The LIHWAP is currently a one-time federal program and is scheduled to end on March 31, 2024. Learn more about the program.
SUPPORTING CHILDREN AND FAMILES
- Approved California’s Five-Year State Prevention Plan for the prevention of child maltreatment and its recurrence. The Department of Social Services has worked diligently with numerous stakeholders to develop a plan that represents California’s vision to integrate a statewide system that supports families to provide safe, stable, nurturing relationships, and environments for their children and youth. As of December 2023, 51 counties and two Tribes have chosen to opt into the Program.
- Provided technical assistance and ultimately preapproved using an alternative methodology to establish subsidized childcare subsidy. This approach will allow California to establish a new, single childcare rate reimbursement structure that reflects the cost of care and will ensure greater access to quality childcare and development services across California.
BIGGER PICTURE: CalHHS is committed to advancing our vision of a Healthy California for All through our guiding principles and strategic priorities. We are working together with our state and local partners, along with the Federal Government, to build a state where all of us can thrive. Together, with a commitment to equity, we are focused on improving the lives of the most vulnerable and iterating on the structure of programs to meet the diverse and unique needs of each community and person we serve.
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