DHCS Stakeholder Update - March 24, 2023
Top News
Governor Newsom's Proposal to Modernize California's Behavioral Health System
Governor Newsom announced next steps to modernize how California treats mental illness and substance use disorders, collectively known as the behavioral health system. His plan includes three key elements: a general obligation bond to fund behavioral health residential facilities along with housing for homeless veterans; a ballot initiative to modernize the Mental Health Services Act; and a proposal to make today's behavioral health system work better for all Californians by improving statewide accountability and access to behavioral health services. DHCS will hold a webinar Wednesday, March 29, to provide more detail on the proposal.
Governor Newsom's Master Plan for Tackling the Fentanyl and Opioid Crisis
On March 20, Governor Newsom released his Master Plan for Tackling the Fentanyl and Opioid Crisis, which builds on the Administration's $1 billion investment to address the opioid crisis. The plan includes steps to support overdose prevention efforts, hold the pharmaceutical industry accountable, crack down on drug trafficking, and raise awareness about the dangers of opioids, including fentanyl. The plan is supported by the Governor's proposed 2023-24 budget—which includes $79 million for Naloxone distribution to be managed by DHCS, $10 million for education and support services grants, and an additional $3.5 million to provide overdose medication to middle and high schools.
Program Updates
CMS Deems California Compliant with Renewal Requirements—Will Continue to Receive Enhanced FMAP
The Consolidated Appropriations Act of 2023 established new conditions for the continuous coverage unwinding and resumption of normal business operations for receiving increased Federal Medical Assistance Percentage (FMAP) after April 1. These conditions included a requirement to conduct Medicaid redeterminations consistent with federal requirements or the implementation of alternative strategies approved by the federal Centers for Medicare & Medicaid Services (CMS). On March 20, CMS determined that California is compliant with all applicable requirements.
Navigators Project: Project Partner Summary
On March 17, the Navigators Project posted the Project Partner Summary, which details enrollment and retention goals, funding amounts, subcontractors, and target populations being served. Additional information, such as work plans, will be released soon to give stakeholders a better understanding of how partners plan to effectively conduct outreach, enroll, retain, and assist individuals in obtaining and/or retaining their benefits. For more information, please visit the Navigators Project webpage.
DHCS to Release Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments (WRP)
DHCS will soon issue Hospital and Skilled Nursing Facility COVID-19 WRP totaling more than $1 billion. DHCS will disperse funds to approved Covered Entities, Covered Services Employers, Physician Group Entities, and Independent Physicians, representing more than 832,000 total workers. Organizations will have 60 days from the receipt of funds to release payments to approved workers, payment requirements and guidance are posted on the WRP webpage to support entities on the overall distribution process. Please email any questions to wrp@dhcs.ca.gov.
Updated Carr vs. Becerra Guidance
On March 17, DHCS published Medi-Cal Eligibility Division Information Letter I 23-18 providing updated guidance to counties based on the March 2 court order from Carr v. Becerra. The guidance provides instructions on reinstating eligibility for certain individuals enrolled in Medicare Savings Programs (MSPs) during the COVID-19 public health emergency from March 1, 2020, through March 31, 2023. DHCS will reinstate eligibility to the individual's original MSP program, and members will remain in their same tier of MSP coverage until their continuous coverage unwinding Medi-Cal renewal is completed. DHCS will also notify individuals about the reinstatement, including providing information about the reimbursement of any out-of-pocket Medicare Part A premiums.
Medi-Cal Rx: Reinstatement Phase III and Provider Learning Tool Announcement
On March 24, Medi-Cal Rx Reinstatement Phase III, Lift 1 will begin for members ages 22 and older. The transition will phase out the Transition Policy for identified Standard Therapeutic Classes, which will lift the override of National Council for Prescription Drug Programs. Additional information is included in the 30-day countdown alert.
Additionally, last week, a scenario-based learning tool was launched for providers to self-test their understanding regarding the submission of prior authorizations in advance of the retirement of the Transition Policy. This tool is available as an online quiz or in a printable PDF format.
Join Our Team
DHCS is hiring! DHCS has an immediate opening for Chief, Medi-Cal Eligibility Division (MCED). This position provides leadership, direction, and coordination of eligibility policy and operations among DHCS, California counties, and the federal government regarding Medicaid and the Children's Health Insurance Program.
DHCS is also hiring for our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS' mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthy lives.
Upcoming Stakeholder Meetings and Webinars
California's Reproductive Health Access Section 1115 Demonstration (CalRHAD): First Public Hearing
On March 29, from 10 to 11 a.m., DHCS will host the first (advance registration required) of two public hearings to solicit stakeholder comments on a proposed CalRHAD Medicaid Section 1115 demonstration. DHCS is seeking approval from CMS to provide competitive grants to reproductive health providers to enhance capacity and access to sexual and reproductive health services, promote the sustainability of California's reproductive health provider safety net, and benefit individuals enrolled in Medi-Cal and other individuals who currently face barriers to such access. Additional information is available on the CalRHAD webpage.
Modernizing the Behavioral Health System Webinar
On March 29, from 3 to 4 p.m., DHCS will host a webinar (advanced registration required) to discuss Governor Newsom's proposal to modernize California's behavioral health system. The Administration plans to work in close partnership with the Legislature, as well as with the California State Association of Counties, other critical local government stakeholders, community-based service organizations, advocates, and people with lived experience as bill language is developed.
Doula Stakeholder Workgroup Meeting
On March 30, from 12 to 2 p.m., DHCS will host the first public virtual stakeholder workgroup meeting regarding doula services. SB 65 requires DHCS to convene a workgroup to examine implementation of the doula benefit in Medi-Cal. The workgroup will discuss ways to ensure that doula services are available to Medi-Cal members, consider ways to minimize barriers and delays in payments to doulas, and recommend outreach efforts so members are aware of available doula services. The meeting registration link will be available on the doula webpage.
CalRHAD: Second Public Hearing
On April 3, from 9 to 10 a.m., DHCS will host the second (advance registration required) public hearing to solicit stakeholder comments on a proposed CalRHAD Medicaid Section 1115 demonstration.
In Case You Missed It
DHCS Awards $1.75 Million to Train Providers on Substance Use Disorders
On March 20, DHCS awarded $1.75 million to 25 programs through the California Residency Program Collaborative Project. This project will advance the training of primary care doctors in the field of substance use disorders (SUD), including stimulants and opioids. The training is part of DHCS' broader efforts to address SUD, collectively known as the California MAT Expansion Project, to increase access to Medication Assisted Treatment (MAT), reduce unmet treatment needs, and reduce opioid overdose-related deaths through the provision of prevention, treatment, and recovery activities.
For more information, please visit the California MAT Expansion Project Overview webpage.
Published COVID-19 Information
