DHCS draft outlines qualified-individual waiver pathways and safeguards

What happened

DHCS and CDSS’s joint draft ACL/BHIN dated September 25 describes approval routes allowing specified placing-agency employees or people connected to placement settings to perform qualified-individual (QI) assessments despite the usual affiliation restriction. Existing QI qualifications, training and assessment guidance are not eliminated. Under the draft, a placing-agency employee cannot assess a child for whom they are or were the caseworker or sit in the relevant casework chain of command. A behavioral health plan (BHP) employee ordinarily needs no waiver unless the specified placement-setting or placing-agency connections exist. This remains draft guidance as of October 4.

The draft’s three BHP/provider routes vary who develops or submits the request, but retain BHP signatures, independence from placement-setting influence, training, attestations and an oversight plan. They do not create unrestricted approval for placement-setting staff to assess current or potential residents: the draft restricts concurrent placement-setting employment and requires tracking of conflicts and employment changes. CDSS would issue a written decision; approval lasts one year, renewal is requested at least sixty calendar days before expiration, and denied renewal disqualifies work under that waiver until a new approval. A separate case-specific tribal route is described, and waivers cannot be shared across counties. The retained dated draft does not establish the historical public-comment deadline; verify that deadline before any submission rather than treating the draft as an issued waiver.

Why it matters

Assessment independence depends on actual casework, employment and ownership relationships, with ongoing monitoring rather than a one-time affiliation waiver alone.

Implementation playbook

1. Internal target: review the September 25 draft’s QI qualifications, independence, casework and employment conflicts, proposed request pathway and oversight responsibilities with operational and legal owners. Clinical Operations · Due 2026-10-09
2. Internal target: verify the applicable public-comment deadline before any proposed submission, record the draft applicability assessment and preserve existing QI requirements pending final guidance and any actual waiver approval. Compliance · Due 2026-10-12

Sources

• Draft BHIN, Qualified Individual Waiver Process OptionsOfficial · DHCS · 2026-09-25 · Source review 2026-10-04
• 2026 Behavioral Health Information NoticesOfficial · DHCS · Source review 2026-10-04