DPSS ePolicy

To convert existing policy to new webpage – No content changes.

Behavioral Health Treatment (BHT) services are now provided under State-only Medi-Cal.

Individuals under 21 years of age with Autism Spectrum Disorder (ASD) who are receiving BHT services from the Regional Centers must be transitioned to Medi-Cal.  These children are eligible under the Home and Community-Based Services (HCBS) Waiver for the Developmentally Disabled (DD) Waiver.

Effective April 1, 2017, individuals under age 21 receiving BHT as their only service from the Regional Centers, will no longer be eligible to participate in the DD Waiver and therefore, must be evaluated for other Medi-Cal programs.

On January 21, 2016, the federal Centers for Medicare and Medicaid Services (CMS) approved State Plan Amendment (SPA) 14-026, which makes BHT services a covered Medi-Cal benefit for individuals under 21 years of age with ASD.

With the approval of BHT as a covered Medi-Cal benefit, all individuals under 21 years of age with ASD who had their eligibility established through institutional deeming rules and received BHT services through the DD Waiver as their only waiver service, will no longer be eligible to participate in the DD Waiver effective April 1, 2017.

The Regional Centers have evaluated all children receiving services from the Centers to identify the type of services they’re receiving.  Individuals under 21 years of age receiving services from the Regional Centers other than BHT, may continue to receive services under the DD Waiver.

Terms and Descriptions

Department of Developmental Services (DDS)

Agency used by the State of California to provide services and support to individuals with developmental disabilities.

Regional Centers

Non-Profit private corporations that contract with DDS to provide or coordinate services and support for individuals with developmental disabilities.

Home and Community Based Services (HCBS) Waiver

1915(c) waiver provides home and community-based services to developmentally disabled persons who are Regional Center consumers.

ME – MAGI Eligible

Code to be used to identify individuals found eligible to MAGI Medi-Cal after eligibility redetermination.

NME – Non-MAGI Eligible

Code to be used to identify individuals found eligible to Non-MAGI Medi-Cal after eligibility redetermination.

NoMC – Not Medi-Cal Eligible

Code to be used to identify individuals found ineligible to Medi-Cal after eligibility redetermination.

Effective with the release of this document, these children must be evaluated for Medi-Cal (MAGI/Non-MAGI) by staff from the Long Term Care (LTC) District #80, where these cases are centralized.

The California DDS has identified the children in Los Angeles County that are receiving BHT as their only waiver service.  DHCS has provided the County an Excel file that contains a list of these children who must now be evaluated for Medi-Cal.

All current and future determinations/redeterminations for DD Waiver, or any waiver participants, should include a full consideration for the family under the Medi-Cal hierarchy.

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