The Office of Family Planning and Family PACT

The Office of Family Planning (OFP) is charged by the California Legislature “to make available to citizens of the State who are of childbearing age comprehensive medical knowledge, assistance, and services relating to the planning of families”. The purpose of family planning is to provide women and men a means by which they decide for themselves the number, timing, and spacing of their children.

The Family Planning, Access, Care, and Treatment (Family PACT) Program is administered by the California Department of Health Care Services, OFP and has been operating since 1997 to provide family planning and reproductive health services at no cost to California’s low-income (under 200% federal poverty level) residents of reproductive age. The program offers comprehensive family planning services, including contraception, pregnancy testing, and sterilization, as well as sexually transmitted infection testing and limited cancer screening services.

News and Updates

Family PACT Telehealth Policy

On June 16, DHCS published telehealth policy updates for the Family PACT Program. Subsequently, on August 16, DHCS published clarification on the definition of “distant site” for purposes of telehealth under Family PACT.

Upcoming Policy Updates

DHCS would like to make providers aware of the following upcoming policy updates for the Family PACT and/or Medi-Cal family planning programs. As these policies are developed and implemented in the system, they will be announced in the Family PACT Update and Medi-Cal Update Bulletins, as applicable.

• Various updates to the Family PACT laboratory services policy.
• Family PACT policy update to allow for billing of Evaluation and Management codes 99204 and 99214 for males without restrictions.
• Addition of nitrofurantoin as a clinic benefit for the Family PACT and Medi-Cal family planning programs.

Family PACT Integration into CalHEERS

The Family PACT client eligibility determination and enrollment transaction portal will transition to the California Healthcare Eligibility, Enrollment and Retention (CalHEERS) in late 2024. This transition will allow individuals interested in family planning services the ability to apply and enroll into the Family PACT Program. Family PACT providers will continue to enroll and re-enroll clients within a new CalHEERS interface. The new portal will help automate the application, eligibility, and management processes to provide a better experience for consumers and Family PACT providers.

DHCS will be granting access to the CalHEERS Family PACT portal utilizing the site certifier for each enrolled Family PACT location. In preparation, DHCS is requesting Family PACT providers update their contact information and site certifier details via the Provider Application and Validation for Enrollment (PAVE) portal. Letters were mailed to all enrolled and actively billing Family PACT providers in mid-August providing instructions on how to update their contact information and site certifier details via PAVE.

Updates will be published in future Family PACT Update Bulletins.

Non-Billing for One Year

The Office of Family Planning would like to remind providers that per W&I code, Section 24005 (i)(3): “The department shall deactivate,… the provider numbers used by a provider to obtain reimbursement from the program when… a provider has not submitted a claim for reimbursement from the program for one year…” Beginning in September, letters will be mailed to providers who did not submit a claim for reimbursement from the program from January 1, 2022 through July 1, 2023, to notify them of their impending deactivation from the Family PACT Program for non-billing. Providers receiving these letters will have 30 days to respond prior to being deactivated from the Family PACT Program.

Family PACT Program Regulations

DHCS anticipates that proposed Family PACT regulations will be on the rulemaking calendar for 2025. For more information on DHCS rulemaking process, please visit DHCS’ Office of Regulations webpage.

Family PACT Program Annual Report

On May 12, DHCS posted the Family PACT Program Fiscal Year 2019-20 Report on the Family PACT website. The statute requires an annual analysis of key program metrics. This annual report is based on enrollment and claims data that describe Family PACT provider and client populations, types of services utilized, and program reimbursement. Dates of service in this report are for fiscal year 2019-20, which began on July 1, 2019, and ended on June 30, 2020. 

California’s Reproductive Health Access Demonstration (CalRHAD)

On June 8, DHCS submitted a new demonstration project under Section 1115 of the Social Security Act, entitled California’s Reproductive Health Access Demonstration (CalRHAD), to the Centers for Medicare & Medicaid Services. This demonstration will play a key role in advancing California’s progress in providing access to comprehensive sexual and reproductive health services for individuals enrolled in Medi-Cal and other individuals who need access to quality, affordable care.

Visit DHCS CalRHAD Webpage for more information.

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Virtual Provider Orientation 2023

• October 12 – conducted via Zoom – from 9:00-11:30 a.m.
• December 14

Visit the Learning Management System (LMS) webpage for registration information.

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Upcoming Provider Training

Webinar: Minor Consent and Confidentiality for Sexual Health Services in California conducted via Zoom – October 25, 2023, from 12:00-1:30 p.m. 

This presentation will provide an overview of the laws that impact minors and their access to confidential sexual health and family planning services in California. It will review important exceptions to confidentiality including mandated child abuse reporting and share some examples of best practices for implementation in difficult situations. Participants will learn about resources to support implementation of minor consent laws and be given an opportunity to test their own knowledge through case studies.

To request a digital accessibility accommodation for this event, please contact Nicole Garcia at Nicole.Garcia@ucsf.edu at least one week in advance of the event.

New DHCS Brand and Logos

DHCS has been working to implement several initiatives to transform Medi-Cal and improve the state’s Medi-Cal program. These historic changes are already making a difference in the lives of Medi-Cal members. With new and improved services, this major transformation will provide Medi-Cal members with access to well-rounded care that goes beyond the doctor’s office or hospital and addresses their physical and emotional needs.

The Medi-Cal transformation aims to create a more coordinated, person-centered, and equitable health system that works for everyone, inclusive of race, ethnicity, gender identity, sexual orientation, disability, language, immigration status, where you live or your health needs.

To better symbolize this important time, DHCS introduced new branding for Medi-Cal and other programs, including Family PACT.

In addition, as part of DHCS’ efforts to provide improved services, DHCS launched an update to the Medi-Cal Providers website, which includes:

• A redesigned branding of the website, which will offer improved aesthetics, functionality and ease of use.
• An improved Publications area of the website to assist providers in finding the information they need.
• Providers will now be able to choose categories from News articles and other site content, allowing access to similarly categorized information more efficiently.

The references page will now feature all references with categories, including frequently asked questions (FAQs) from across the site, making it easier to locate relevant information and find answers to common queries.

Keeping Medi-Cal Beneficiaries Covered

Planning for the End of the Continuous Coverage Requirement

The COVID-19 Public Health Emergency will end soon and millions of Medi-Cal beneficiaries may lose their coverage. DHCS’ top goal is to minimize beneficiary burden and promote continuity of coverage.

How You Can Help

1. Sign Up and Become a DHCS Coverage Ambassador
   The DHCS Coverage Ambassadors will be trusted messengers made up of diverse organizations that can reach beneficiaries in culturally and linguistically appropriate ways. Additionally, DHCS Coverage Ambassadors will connect Medi-Cal beneficiaries at the local level with targeted and impactful communication. Join the DHCS Coverage Ambassador mailing list to receive the latest information and updated toolkits as they become available.
2. Raise Awareness
   Download the updated Medi-Cal Continuous Coverage Toolkit and start educating beneficiaries

For more information, visit DHCS website.

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