(a) The department shall submit an application to the federal Centers for Medicare and Medicaid Services for a waiver or a demonstration project to implement all of the following:

1. (1) Strengthen California’s health care safety net, which includes disproportionate share hospitals, for low-income and vulnerable Californians.
2. (2) Maximize opportunities to reduce the number of uninsured individuals.
3. (3) Optimize opportunities to increase federal financial participation and maximize financial resources to address uncompensated care.
4. (4) Promote long-term, efficient, and effective use of state and local funds.
5. (5) Improve health care quality and outcomes.
6. (6) Promote home-and community-based care.

(b) The waiver or demonstration project shall include proposals to restructure the organization and delivery of services to be more responsive to the health care needs of Medi-Cal enrollees for the purpose of providing the most vulnerable Medi-Cal beneficiaries with access to better coordinated and integrated care that will improve their health outcomes, slow the long-term growth of the Medi-Cal program, and continue support for the safety net care system and the persons who rely on that system for needed care. These restructuring proposals may include, but are not limited to, the following:

1. (1) Better care coordination for seniors and persons with disabilities, dual eligibles, children with special health care needs, and persons with behavioral health conditions, which shall include the establishment of organized delivery systems that incorporate a medical home system and care and disease management, as well as incentives that reward providers and beneficiaries for achieving the desired clinical, utilization, and cost-specific outcomes.
2. (2) Improved coordination between Medicare and Medi-Cal coverage.
3. (3) Improved coordination of care for children with significant medical needs through improved integration of delivery systems and use of medical homes and specialty centers, and providing incentives for specialty and nonspecialty care.
4. (4) Improved integration of physical and behavioral health care.

(g)

1. (1) The department shall only implement the waiver or demonstration project upon submittal of an implementation plan, pursuant to Section 14181, to the appropriate policy and fiscal committees of the Legislature at least 60 days prior to any appropriation.
2. (2) Pursuant to paragraph (1), mandatory enrollment in any organized delivery system authorized pursuant to a waiver or demonstration project authorized pursuant to this article shall only occur when funds necessary to support that effort have been appropriated.
3. (3) It is the intent of the Legislature to neither impede nor limit the department’s existing statutory authority regarding the operation of the Medi-Cal program and its health care delivery systems by the enactment of this article.