Medi-Cal: field medicine.

Assembly Member Mark González, working with his colleagues, advances a new Medi-Cal field medicine framework aimed at addressing the health needs of people experiencing homelessness while coordinating with existing Medi-Cal provisions and awaiting federal approvals. The core change authorizes Medi-Cal managed care plans to elect to deliver Medi-Cal covered services through in-network, contracted field medicine providers and requires that, if a plan makes this option available, a Medi-Cal member who is experiencing homelessness may receive those services directly from a field medicine provider regardless of the member’s in-network assignment. The framework also obligates plans to establish referral and authorization mechanisms and to maintain care-coordination and timely communication among the field medicine provider, the plan or IPA, and the member’s primary care provider, with a separate reimbursement pathway for field medicine services delivered in the fee-for-service Medi-Cal delivery system.

Key definitions and implementation details emphasize that “field medicine” is a set of health and social services delivered on-site to people experiencing homelessness, with providers conducting visits outside traditional facilities. The bill defines a “field medicine provider” as a licensed medical professional who conducts such visits in settings where homelessness is experienced. Implementation hinges on securing any necessary federal approvals and on federal financial participation being available, and it is intended to coexist with, rather than duplicate, existing Medi-Cal benefits such as community health worker services, enhanced care management, and community supports. In addition, the department would provide a mechanism for a member to disclose homelessness online, in person, or by telephone, and the department would inform plans when homelessness is indicated on the Medi-Cal application.

The legislation also undertakes a broad reform of eligibility and enrollment processes for insurance affordability programs. It replaces disparate intake approaches with a single, standardized application for Medi-Cal, CHIP, and exchange-based coverage, developed in coordination with the Exchange board. The application framework permits supplemental forms for non-financial criteria, supports prepopulation and self-attestation where permitted, and requires electronic verification and timely processing. A new optional homelessness-identification question would be included in the standard application by January 1, 2027, and the bill requires accessibility, plain language, and multilingual compliance, along with a stakeholder-feedback process to monitor system functionality and address defects. It also contemplates cross-program transfers to minimize gaps in coverage and directs that counties be engaged in related data-sharing or eligibility activities, with potential local-mandated costs subject to reimbursement rules if applicable.

Implementation and fiscal considerations center on the dependency on federal approvals and funding, the absence of an explicit new state appropriation in the text, and the possibility of local costs if counties assume new duties. The bill mandates coordination between the department and the Exchange to align eligibility rules across programs, strengthen privacy protections, and enhance data governance, particularly around a homelessness indicator and cross-program data-sharing. Taken together, the provisions situate field medicine as a new, optional care model within Medi-Cal that can be adopted by plans and integrated with broader CalAIM-era eligibility reforms, while preserving non-duplication with existing benefit categories and requiring a careful, federally informed implementation timeline.