State outlines Behavioral Health Transformation measures, will share specifications with plans by June
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Summary
DHCS presented a phased performance-measure approach for Behavioral Health Transformation, describing temporary Phase 1 public measures and a larger Phase 2 set tied to individual Medi-Cal data for planning and accountability; DHCS said it identified roughly 43 measures so far and will release specifications to plans by June 30.
Anna Nafee, a consulting psychologist leading quality and equity work at the California Department of Health Care Services, told the Provider Advisory Committee on Feb. 24 that DHCS has developed a two-stage measure strategy to guide the Behavioral Health Transformation (BHT) set out under SB 326.
"All Californians have access to behavioral health care services leading to longer, healthier and happier lives," Nafee said, summarizing the vision that shaped the 14 statewide goals. She described Phase 1 as a temporary set of publicly available measures counties already use for integrated planning and Phase 2 as an individual-level, attributable measure set calculated in Medi-Cal Connect that will allow DHCS and plans to identify which part of the system is accountable for performance.
Why this matters: the BHT measures are intended to drive planning, monitor population-level outcomes and, over time, support accountability tied to the Behavioral Health Services Act implementation. Draft integrated plans are due in March and final plans must be submitted in June, with new measures and accountability timelines aligned to those planning cycles.
DHCS said Phase 2 will be larger and more granular than Phase 1. Nafee said the department is working toward "a measure set of about 50 to 70 measures," and has identified roughly 43 measures across the first 10 goals so far. Examples include population-level and intervention-level measures for homelessness (population prevalence among people with significant behavioral health needs; permanent housing outcomes and delivery of full-service partnership housing services), institutionalization baselines, transition-of-care and follow-up measures, juvenile and parental supports, and measures for suicide, repeat nonfatal self-harm, overdose and treatment access.
DHCS also emphasized equity features: most measures will be stratifiable in Medi-Cal Connect by age, race, ethnicity and other demographics, and the department plans about four "bold" health-equity measures to set state targets for closing gaps.
On accountability and timing, Nafee said DHCS will share Phase 2 specifications with behavioral health and managed care plans via Medi-Cal Connect by June 30 and release them to the broader public later in the summer. "We will not issue corrective action for performance until after the second integrated plan period," she told the committee, explaining the department wants time to stabilize de novo measures and understand initial baselines before formal corrective steps.
Committee members and public commenters pressed DHCS on data linkage and practical measurement issues. Commissioner Mike Bernick asked how employment outcomes will be measured; Nafee said the technical subcommittee is voting on employment-related measures and the department is engaging with EDD and the Franchise Tax Board to acquire wage and employment datasets for linkage. Public commenters representing Los Angeles County planning teams and NAMI Urban LA asked that state-level engagement explicitly leverage existing local community planning teams to avoid duplicative outreach and ensure local voices are represented in planning and monitoring.
On measuring suicide and overdose, Nafee told the committee that claims and administrative data cannot fully determine intentionality. "Nobody can account for intentionality," she said, and explained DHCS will focus on repeat events and follow-up care as actionable metrics where the health system can intervene.
What happens next: DHCS will continue measure specification work, finalize cohort 3 and equity measures by June, and release Phase 2 specifications to plans by June 30; the department anticipates an iterative monitoring period as initial baselines are calculated.
Sources: Presentation and Q&A with Anna Nafee, Department of Health Care Services, and subsequent public comments at the Provider Advisory Committee meeting on Feb. 24, 2026.
