Under the BH-CONNECT initiative, Behavioral Health Plans (BHPs) may participate in the Access, Reform and Outcomes Incentive Program ("Incentive Program") and earn performance-based incentives for demonstrating improvements in access to behavioral health services and outcomes among Medi-Cal members living with significant behavioral health needs.

This letter of commitment to DHCS confirms the BHP (1) has a need for funding to improve performance on the access, outcomes, and delivery system reform measures included in the Incentive Program and (2) intends to participate in the Incentive Program. Letters of commitment must be submitted by March 31, 2025.

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* 1. County Name:

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* 2. Contact Information of Respondent:

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* 3. Has the BHP completed the Targeted Managed Behavioral Healthcare Organizations (MBHO) Self-Directed Assessment with the National Committee for Quality Assurance (NCQA) described in BHIN 24-019?

Please note that BHPs must have completed the Targeted MBHO Self-Directed Assessment with NCQA by October 31, 2024 to participate in the Incentive Program.

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* 4. Behavioral Health Director Certification Statement:

I certify on behalf of the BHP named in this letter of commitment the BHP's (1) need for funding to improve performance on the access, outcomes, and delivery system reform measures included in the Incentive Program and (2) decision to opt-in to the Incentive Program and verify that, to the best of my knowledge, all information provided in this letter of commitment is true and accurate.

Please enter your full name and contact information below to confirm:

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