Behavioral health and Medi-Cal
CalFina has worked on California behavioral health and Medi-Cal programs for more than eight years, from federal screening compliance to county claiming and CalAIM Justice-Involved stabilization.
CalAIM Justice-Involved
CalFina helped launch the CalAIM Justice-Involved Initiative with the first wave of counties, advising counties on how to redesign their electronic health record systems to meet State requirements.
In 2025 and 2026, CalFina led stabilization of the County of San Mateo's justice-involved Medicaid program after go-live: diagnosing claims workflow errors, coordinating correctional facilities, county operations, pharmacy, public health, and the State, and building the corrective action plan. See the case studies.
County behavioral health claiming
Short-Doyle is the California Department of Health Care Services (DHCS) behavioral health claims system: $2B+ in annual reimbursements across 55+ county programs.
Rajesh was project manager and QA lead from 2015 to 2018, while at Cambria Solutions. Reimbursements were delivered 100% on time across all counties. Since 2022, CalFina staff have supported maintenance and operations as a subcontractor to Deloitte Consulting LLP.
The work helped deliver the Drug Medi-Cal Organized Delivery System (DMC-ODS) and the CalAIM behavioral health reforms in Short-Doyle. CalFina staff now support the system through the Behavioral Health Services Act (BHSA) changes.
PASRR: California and Ohio
Preadmission Screening and Resident Review (PASRR) is the federal screening requirement for people with serious mental illness or intellectual disability entering nursing facilities.
California. Rajesh led the DHCS program that brought California into compliance in three months, after more than 20 years of noncompliance, and trained 1,400+ nursing facilities. The project won the 2015 Best Team IT Project for the State of California.
Ohio. Rajesh was project and delivery manager for the Ohio Department of Mental Health and Addiction Services PASRR system in 2015.
Both were delivered while Rajesh was at Cambria Solutions.
Community-based organizations
In 2026, CalFina is lead consultant for community-based organizations (CBOs) preparing to deliver CalAIM Enhanced Care Management (ECM) and Community Supports to Medi-Cal members, through a county coalition technical assistance program.
The work covers DHCS policy, managed care plan contracting, Domain 3 implementation, Medi-Cal compliance, and program design, and is delivered remotely.
Working with DHCS behavioral and mental health programs
CalFina's work with California Department of Health Care Services (DHCS) behavioral and mental health programs goes beyond systems. It spans every Short-Doyle engagement and PASRR, and includes:
Short-Doyle (2015 to 2018 and 2022 to present) and California and Ohio PASRR. Short-Doyle work helped deliver the Drug Medi-Cal Organized Delivery System (DMC-ODS) and the CalAIM behavioral health reforms, and CalFina staff now support it through the Behavioral Health Services Act (BHSA) changes.
The work has involved three DHCS divisions: Medi-Cal Behavioral Health – Policy, Community Services, and Behavioral Health Oversight and Monitoring.
Medi-Cal scale
Beyond behavioral health, CalFina's Medi-Cal work includes Medi-Cal Rx, the statewide Medi-Cal pharmacy benefit: $17B in annual pharmacy spend serving 18M+ beneficiaries.
Also served as Enterprise Solutions Architect. The Medi-Cal Rx certification received no conditional findings from CMS. See Case studies.
Behavioral health work at a glance
- PASRR, California
- 2014 to 2015
- PASRR, Ohio
- 2015
- Short-Doyle
- 2015 to 2018, and 2022 to present
- CalAIM Justice-Involved
- 2025 to 2026