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Waiver Reports

California’s health system includes statewide public coverage programs and special county-based programs: Medi-Cal, Healthy Kids/Healthy Families, and others created under Section 1115 of the Social Security Act.


Transforming Drug Medi-Cal: Key Considerations for a Waiver Amendment

California’s expanded Medi-Cal program and expanded Substance Use Disorder (SUD) benefit provides an opportunity for beneficiaries to access improved services through the Drug Medi-Cal (DMC) program. In California, 1.9 million individuals are newly enrolled in Medi-Cal in 2014, [1] and an anticipated 147,000 to 195,000 of these individuals are in […] more

Summary of §1115 Waiver

Introduction The §1115 Waiver provides a bridge or stepping-stones to implementation of the Affordable Care Act of 201o (ACA). The projected value to the state is more than $10 billion in federal match over the next five years. This briefing paper describes the evolution from our current system to the […] more

California’s §1115 Waiver Implementation

Introduction California’s §1115 waiver,[1] approved on November 1, 2010, provides the vital infrastructure to bridge current coverage options into 2014 and offers immediate support and relief to the financially hard pressed[2] safety net system and the individuals they serve.  Local communities face the challenge of implementing three new programs at […] more

Waiver Implementation Update (Oct 2011)

The §1115 waiver approved for California on November 1, 2010 provides a bridge and other vital infrastructure to coverage in 2014 and offers immediate support and relief to the financially hard pressed safety net system and the individuals they serve. Local communities face the challenge of implementing three new programs […] more

ITUP Summary of Counties’ LIHP Applications

On March 18th, we noted that DHCS had recently published copies of 26 counties’ applications for the Waiver’s Low Income Health Program (LIHP). Based on the projections in their applications, counties predict the total number of people covered under the LIHP to be approximately 455,000, — with the vast majority […] more

§1115 Waiver Resources

Counties across the state are starting to gear up for full implementation of the new §1115 waiver: the SPD population is being transitioned to managed care, applications for the Low Income Health Program are being reviewed, and DHCS recently released the final Request for Proposal (RFP) for four counties to […] more

ITUP Summary of California’s §1115 Waiver

Introduction The §1115 Waiver provides a bridge or stepping-stones to implementation of the Affordable Care Act of 201o (ACA). The projected value to the state is more than $10 billion in federal match over the next five years. This briefing paper describes the evolution from our current system to the […] more

Summary of §1115 Waiver Renewal

Summary of California’s renewed federal waiver. more

Thoughts on §1115 Waiver’s Expansion of Managed Care

The §1115 waiver proposes to expand Medi-Cal managed care in the following ways: Expansion for the seniors and persons with disabilities (also known as the SPD’s) Mandatory enrollment in managed care for 380,000 individuals, accounting for an estimated $7.5 billion in spending County alternative option (managed care for outpatient services, […] more

Waiver Legislation: Update and Summary

In June, the Department of Health Care Services (DHCS) submitted an initial waiver proposal to the federal Centers for Medicare and Medicaid Services (CMS). CMS is currently reviewing the proposal and will offer feedback to DHCS who will then submit a final waiver application no later than September 1, 2010. […] more