Bill > SB324

This bill modifies California's Medi-Cal program (the state's Medicaid program) to enhance how Enhanced Care Management (ECM) and Community Supports are delivered to low-income beneficiaries. The bill requires Medi-Cal managed care plans to contract with local community providers who can demonstrate their capability to provide high-quality services, with an emphasis on giving preference to providers with direct experience serving Medi-Cal beneficiaries in their county. These community providers can include nonprofit organizations that offer health-related social services. The bill mandates that managed care plans must honor member preferences by allowing a preferred community provider to deliver services if they are capable, and requires the Department of Health Care Services to set goals every two years to increase contracting with community providers. Additionally, the bill changes reporting requirements, mandating quarterly (instead of annual) public reports on service utilization with more detailed demographic data, and requires the department to develop standardized templates and guidance to help community providers more easily contract with managed care plans, including allowing them to act as primary subcontractors and work with other community providers. The goal is to make Medi-Cal services more accessible, locally responsive, and tailored to the specific needs of vulnerable populations like people experiencing homelessness, high healthcare utilizers, and individuals with complex medical or behavioral health needs.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB324