FAQs
The following are frequently asked questions related to the Behavioral Health Centers of Excellence (COE).
For questions related to the Behavioral Health Services Act (BHSA) and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) initiative Evidence-Based Practices (EBP) overlap, please reference the BHSA and BH-CONNECT EBP Overlap FAQ document.
For questions related to the BH-CONNECT initiative, please review the BH-CONNECT FAQ page.
Have a question or comment? Please reach out to us to share your questions and feedback. We value your expertise and experience.
Search the Frequently Asked Questions
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State law permits counties with a population of less than 200,000 to request exemptions from offering Assertive Community Treatment (ACT) and Forensic ACT (FACT), and/or Individual Placement and Support (IPS) Supported Employment in their Full Service Partnership (FSP) programs under the BHSA. More information is available in the BHSA Policy Manual. While counties that receive FSP EBP exemptions are not required to offer ACT, FACT, and IPS services or meet BHSA fidelity thresholds and timelines, counties are strongly encouraged to identify county-operated or contracted providers to receive training and technical assistance from state-sponsored COEs for free.
HFW is an FSP requirement for all counties. Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) is required as part of Behavioral Health Services and Supports Early Intervention (BHSS-EI) programs.
Topics:
- Evidence-Based Practice (EBP)
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As noted in the Evidence-Based Practice Training, Technical Assistance, Fidelity Monitoring and Data Collection Policy Manual, the first date of service will start the clock for BHSA and BH-CONNECT requirements for established teams:
“An “established” team reflects a group of practitioners that has been staffed according to the standards of the EBP and is beginning to deliver and be paid for services delivered to individuals living with behavioral health needs. A “team” is a multidisciplinary group of practitioners that are delivering services to a specified caseload of members and participating in fidelity assessments; the structure and size of a team may shift over time, including as a result of staff turnover.”
The first date of service will start the clock for the 9-month timeline to the baseline fidelity assessment (and must occur no later than December 31, 2027, under BHSA) and 15-month timeline to first fidelity assessment (and must occur no later than June 30, 2028, under BHSA).
Topics:
- Other
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To ensure timely continuous quality improvement (CQI) and monitoring of team performance, county-operated and county-contracted behavioral health practitioners are required to report data directly to each COE. Direct data reporting from behavioral health practitioners to the COEs was intended by DHCS to alleviate data reporting burden on county behavioral health plans (BHP) and reduce delays in COE required data reporting to DHCS. This data is also key to supporting timely CQI and monitoring of team performance as part of COE training and technical assistance supports.
Additionally, the key roles of behavioral health practitioners, counties, COEs, and DHCS in implementing the EBPs are further outlined on the Resource Hub. Please see BH-CONNECT and BHSA EBP Requirements: Key Roles and the EBP Training, Technical Assistance, Fidelity Monitoring and Data Collection Policy Manual for more information.
DHCS is exploring options for county BHPs to have line of sight into behavioral health practitioner reported data submitted to COEs.
Topics:
- Data Collection & Reporting
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All COEs are required to report on a common set of aggregate provider-level data elements to DHCS to support tailored training and technical assistance to BH practitioners and support achievement of certification or licensing, accreditation, and/or EBP fidelity. EBP program-specific client-level outcomes are also required to support the BH-CONNECT Incentive Program.
In addition, each EBP requires behavioral health practitioners to report unique data via data tools that reflect each EBP’s specific training and technical assistance and fidelity monitoring approach. For further information on each EBP’s data tools, please see the Data Assessment Tools Required for Behavioral Health Practitioners and Behavioral Health COE January 2026 Office Hours Slides.Additional information on data requirements can be found on the BH-CONNECT and BHSA EBP Requirements: Key Roles webpage and EBP Training, Technical Assistance, Fidelity Monitoring and Data Collection Policy Manual.
Topics:
- Data Collection & Reporting
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COEs collect individual client-level data using COE-specific assessment tools to support outcome measurement of clients served.
Topics:
- Data Collection & Reporting
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As part of FFT LLC’s training protocol, an externship is required for clinical team supervisors only. This intensive, hands-on, training experience with actual clients includes supervision from behind the mirrored window at an off-site location. The externship consists of three separate training experiences over three consecutive months. Travel may be in state or out of state, and costs are covered by the DHCS Behavioral Health COE.
Topics:
- Functional Family Therapy (FFT)
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Daily progress notes, along with treatment planning, are essential to demonstrate medical necessity. Documentation must substantiate the rehabilitative intent, member participation, and linkage to individualized goals. Clubhouse services should maintain comprehensive attendance logs, progress notes, and evidence of ongoing care planning, all of which should be integrated into service delivery. This ensures compliance with Medi-Cal requirements. Qualified Clubhouse staff who deliver the service can complete progress notes, allowing for accurate and timely documentation.
Topics:
- Clubhouse Services
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County-operated and contracted behavioral health practitioners across California are eligible for free training and technical assistance from the Centers of Excellence (COE). County behavioral health plans (BHP) must engage with the COEs by submitting an Engagement Initiation Form (EIF). At the initial county consultation, county BHPs will identify practitioners to receive training and technical assistance.
Topics:
- Centers of Excellence
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County BHPs (in their oversight role as a health plan) are not required to share client-level data with the COEs. Behavioral health practitioners (either county-operated or county-contracted providers) that engage with the COEs will share data with the COEs for the purposes of consultation, training and technical assistance, fidelity monitoring, and outcomes reporting per the Evidence-Based Practice Training, Technical Assistance, Fidelity Monitoring and Data Collection Policy Manual for Assertive Community Treatment (ACT), Forensic ACT (FACT), Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP), and Individual Placement and Support (IPS) Supported Employment.
Topics:
- Data Collection & Reporting
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Each state-sponsored COE is expected to support county administrators in their responsibility for monitoring the performance of their county-operated and/or contracted providers, including sharing provider performance metrics, progress on Evidence-Based Practice (EBP) implementation, and engagement in training and technical assistance. Depending on the EBP, COEs may also share provider achievement of fidelity milestones; certification, license or accreditation status; and aggregated client outcomes. These performance metrics should be explicated in the COE practitioner agreements with behavioral health practitioners and shared with county administrators to support programmatic oversight.
Topics:
- Data Collection & Reporting
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Identifiable individual-level client data may be reported to the COE for the sole purpose of supporting consultation to achieve Evidence-Based Practice (EBP) certification or licensing, accreditation, and/or EBP fidelity. Additionally, specific client-level outcomes are required as outlined in the Evidence-Based Practice Training, Technical Assistance, Fidelity Monitoring and Data Collection Policy Manual for Assertive Community Treatment (ACT), Forensic ACT (FACT), Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP), and Individual Placement and Support (IPS) Supported Employment. To support DHCS’ role in the oversight and monitoring of counties and their providers, only aggregated, de-identified data will be shared from the COEs to the COE Administrative Entity (Health Management Associates [HMA]) and DHCS.
Topics:
- Data Collection & Reporting
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Data reported to the COEs cannot be used for research purposes unless it is mutually agreed upon between the behavioral health practitioner team and COE through practitioner agreements (e.g., service use agreement [SUA] or data use agreement [DUA]).
Topics:
- Data Collection & Reporting
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Regarding the Behavioral Health Services Act (BHSA) requirement that counties must include HFW in their Full Service Partnership (FSP) program beginning July 2026, counties can fulfill this requirement by:
- Submitting an Engagement Initiation Form (EIF) for HFW by March 31, 2026.
- Completing the initial county consultation with the HFW Center of Excellence (COE) by June 30, 2026.
- Remaining engaged with the COE.
Topics:
- High Fidelity Wraparound (HFW) ,
- Other California Behavioral Health Initiatives
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Counties that do not opt in to cover EBPs under BH-CONNECT must still meet all BHSA requirements, including providing CSC for FEP as part of their Behavioral Health Services and Supports (BHSS) – Early Intervention (EI) programs. Please see Chapter 7, Section A.7 of the BHSA Policy Manual for more information.
Please see additional resources for more information:
Topics:
- Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) ,
- Other California Behavioral Health Initiatives
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Yes, counties must provide HFW under the BHSA, as described in the BHSA Policy Manual. Additional guidance on Medi-Cal requirements for HFW is also forthcoming from DHCS.
Topics:
- High Fidelity Wraparound (HFW) ,
- Other California Behavioral Health Initiatives
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CSC is appropriate for any individual for whom the service is medically necessary. Past research indicates that in most cases, CSC is appropriate for adolescents and young adults up to age 40; however, DHCS recognizes that in some cases CSC is appropriate for older adults. If a county opts to cover CSC under Medi-Cal, CSC must be available to all members for whom it is medically necessary. More information about service criteria for CSC is in the BH-CONNECT EBP Policy Guide.
Topics:
- Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP)
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Clubhouse Services is an optional Medi-Cal benefit that is not required under the Behavioral Health Services Act (BHSA). There is no deadline to opt in to provide Clubhouse Services under Medi-Cal. Additional information about how counties can opt in to cover Clubhouse Services and other optional Medi-Cal benefits under BH-CONNECT is available in BHIN 25-009.
Topics:
- Clubhouse Services ,
- Policy/Advocacy
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Yes, all ACT and FACT teams must meet training and fidelity monitoring standards. DHCS is developing guidance that outlines training and fidelity monitoring requirements for counties and EBP practitioners.
Topics:
- Assertive Community Treatment (ACT) ,
- Forensic Assertive Community Treatment (FACT)
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Yes, PCIT International will support providers in understanding infrastructure and equipment needs for PCIT. The Implementation Specialist assigned to the provider agency will assist in tailoring the technology recommendations to the particular agency. There are a variety of options and price points for “PCIT Suites,” from observation windows to video observation to telehealth platforms, as well as for bug-in-the-ear devices and toys. PCIT International will work with each provider agency to find the best fit for their practice.
Topics:
- Parent-Child Interaction Therapy (PCIT)
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Staff turnover is common. FFT LLC would not stop certifying a team if it loses staff as long as it continues to meet the team size standards (three to eight therapists) by hiring new staff. FFT LLC will offer weekly virtual “Replacement Training” for any new staff hired that will be joining an already trained and certified FFT LLC team.
Topics:
- Functional Family Therapy (FFT)
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Yes. Based on the body of research including an independent study that evaluated the effectiveness of MST when delivered without the agency and team receiving ongoing continuous quality improvement (CQI) and quality assurance (QA) processes, there is clear evidence that the ongoing CQI and QA processes are vital to model implementation and in obtaining sustained treatment gains.
Topics:
- Multisystemic Therapy (MST)
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The MST inclusionary and exclusionary criteria are based on the youth involved in the initial randomized studies of MST, which were 12-17 years old; therefore, this is the population that the model is demonstrated to successfully treat. However, there are occasions when a youth outside of our age range can be successful in MST. This exception process, facilitated by the MST expert in collaboration with the team supervisor and referrer, assesses if the problematic behavior and other systems variables meet the inclusionary criteria of the model other than the age range. This assessment progress is completed quickly upon referral, so the youth can either begin MST treatment quickly or be referred to a better suited program. MST’s aim is to ensure providers can serve all youth and their ecology who would benefit from MST while also ensuring the model is the best fit for the client.
Topics:
- Multisystemic Therapy (MST)
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DHCS has contracted with the COEs to provide training, technical assistance, fidelity monitoring, and data collection support. Training and support are free of charge for counties and behavioral health providers that serve the Medi-Cal and/or uninsured population. COE support is available to counties and providers beginning in August 2025.
Topics:
- Behavioral Health Plan (BHP) ,
- Centers of Excellence ,
- Evidence-Based Practice (EBP)
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Yes, COEs will support county-operated and county-contracted behavioral health practitioners that serve the Medi-Cal and/or uninsured populations. COEs will work with counties to identify practitioners to participate in training, technical assistance, and fidelity monitoring for each Evidence-Based Practice (EBP).
Topics:
- Behavioral Health Plan (BHP) ,
- Evidence-Based Practice (EBP)
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Yes, the EIF will need to be submitted even if the county is receiving training and technical assistance from the designated COE.
Topics:
- Behavioral Health Plan (BHP) ,
- Evidence-Based Practice (EBP)
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County behavioral health agency directors or designees should submit an Engagement Initiation Form (EIF) to initiate a consultation with one or more COEs. The county contact will receive a follow-up email from the respective COE to schedule consultation within three business days.
Topics:
- Behavioral Health Plan (BHP) ,
- Evidence-Based Practice (EBP)
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Assertive Community Treatment (ACT) and Forensic ACT (FACT), Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP), Individual Placement and Support (IPS) Supported Employment, and High Fidelity Wraparound (HFW) are included in both BH-CONNECT and the BHSA.
As part of BH-CONNECT, DHCS received approval from the Centers for Medicare & Medicaid Services (CMS) to cover Clubhouse Services as a Medi-Cal benefit. DHCS is also clarifying Medi-Cal coverage requirements for Multisystemic Therapy (MST), Functional Family Therapy (FFT), and Parent-Child Interaction Therapy (PCIT) under BH-CONNECT. There are no EBPs required under the BHSA that are not also part of the BH-CONNECT initiative.
Topics:
- Assertive Community Treatment (ACT) ,
- Centers of Excellence ,
- Clubhouse Services ,
- Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) ,
- Evidence-Based Practice (EBP) ,
- Forensic Assertive Community Treatment (FACT) ,
- Functional Family Therapy (FFT) ,
- High Fidelity Wraparound (HFW) ,
- Individual Placement and Support (IPS) Model of Supported Employment ,
- Multisystemic Therapy (MST) ,
- Parent-Child Interaction Therapy (PCIT) ,
- Policy/Advocacy
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The following organizations have been selected to serve as Behavioral Health COEs.
- The Public Mental Health Partnership at the UCLA Semel Institute for Neuroscience and Human Behavior (PMHP at UCLA) to support Assertive Community Treatment (ACT) and Forensic ACT (FACT).
- Clubhouse International to support Clubhouse Services.
- Early Psychosis Intervention California (EPI-CAL) to support Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP).
- The IPS Employment Center at RFMH, Inc.to support Individual Placement and Support (IPS) Supported Employment.
- FFT LLC to support Functional Family Therapy (FFT).
- Resource Center for Family-Focused Practice (RCFFP) at UC Davis Human Services.
- MST Services, LLC to support Multisystemic Therapy (MST).
- PCIT International Association to support Parent-Child Interaction Therapy (PCIT).
Topics:
- Assertive Community Treatment (ACT) ,
- Centers of Excellence ,
- Clubhouse Services ,
- Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) ,
- Forensic Assertive Community Treatment (FACT) ,
- Functional Family Therapy (FFT) ,
- High Fidelity Wraparound (HFW) ,
- Individual Placement and Support (IPS) Model of Supported Employment ,
- Multisystemic Therapy (MST)
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DHCS has partnered with Health Management Associates (HMA) as the Administrative Entity for the Behavioral Health Centers of Excellence (COE). In this role, HMA will:
- Provide project management and oversee the COEs.
- Coordinate technical assistance efforts on Evidence-Based Practices (EBP) to county behavioral health entities, their providers, and systems.
- Support DHCS in standardized data collection and reporting.
- Collaborate with internal and external stakeholders across behavioral health initiatives, as appropriate.
Topics:
- Evidence-Based Practice (EBP)
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The following EBPs are being supported by the Behavioral Health COEs under this initiative:
- Assertive Community Treatment (ACT) and Forensic ACT (FACT).
- Clubhouse Services.
- Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP).
- Individual Placement and Support (IPS) Supported Employment.
- Functional Family Therapy (FFT).
- High Fidelity Wraparound (HFW).
- Multisystemic Therapy (MST).
- Parent-Child Interaction Therapy (PCIT).
Topics:
- Assertive Community Treatment (ACT) ,
- Centers of Excellence ,
- Clubhouse Services ,
- Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) ,
- Evidence-Based Practice (EBP) ,
- Forensic Assertive Community Treatment (FACT) ,
- Functional Family Therapy (FFT) ,
- High Fidelity Wraparound (HFW) ,
- Individual Placement and Support (IPS) Model of Supported Employment ,
- Multisystemic Therapy (MST) ,
- Parent-Child Interaction Therapy (PCIT)
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DHCS has established Behavioral Health COE to support behavioral health delivery systems and behavioral health practitioners in implementing Evidence-Based Practices (EBP). Specific activities conducted by COEs include:
- Training.
- Certification and Medi-Cal Designation for specific EBPs.
- Technical assistance.
- Fidelity monitoring.
- Other supports to deliver EBPs through a culturally sensitive lens.
Topics:
- Evidence-Based Practice (EBP)