DHCS Stakeholder News - April 14, 2023
Program Updates
Update: Long Term Care Benefit Standardization and Transition of Members to Managed Care
DHCS published
All Plan Letter (APL) 23-004 and updated the
frequently asked questions (FAQ) for the skilled nursing facilities (SNF) long-term care carve-in based on stakeholder feedback. The APL includes updates on transportation to recurring appointments, provider communication on billing protocols, and exclusive services not subject to the directed payment policy. It also includes a new long-term services and supports liaison requirement. The FAQ and additional resources are available on the
DHCS LTC Carve-In webpage.
SNFs experiencing challenges contacting their managed care plans (MCP) should email
MCQMD@dhcs.ca.gov for assistance.
California Statewide Automated Welfare System (CalSAWS) Migration Wave Three
On April 24, Orange, Santa Barbara, and Ventura counties will join the CalSAWS consortium. This migration is part of the state's plan to move all 58 counties, by December 31, 2023, to CalSAWS from the current split between two eligibility and enrollment systems: California Work Opportunity and Responsibility to Kids Information Network (CalWIN) and CalSAWS.
During the migration, the CalWIN system will be unavailable for the migrating counties from 5 p.m. on April 20 until they are active in CalSAWS on April 24 at 7:30 a.m. CalSAWS will be unavailable starting on April 21 at 3:30 p.m., and will be back online on April 24 at 7:30 a.m. The statewide application portal (
BenefitsCal) will be available to applicants and members in these counties on April 24. There should be no disruption to the other ten CalWIN counties during this time.
Local county social services offices will be available on April 21 to address emergency services only. CalWIN counties will also have access to a CalWIN environment to allow county staff to see current case information and issue emergency benefits, as needed. Additionally, the CalWIN web portal will redirect applicants and members to county websites and Covered California to apply for benefits.
Opening Soon: Providing Access and Transforming Health (PATH) Justice-Involved Round 3 Funding Application
On May 1, DHCS will open the
PATH Justice-Involved Initiative Round 3 application. Round 3 funding will support correctional agencies, county behavioral health agencies, and other justice-involved stakeholders as they implement personnel, capacity, and/or IT systems that are needed for collaborative planning and implementation of pre-release service processes. For more information, visit the
Justice-Involved Capacity Building Program website.
Medi-Cal Rx
On April 21, Reinstatement Phase III, Lift 2 of the Medi-Cal Rx Reinstatement plan will be implemented, lifting the Transition Policy for 17 Standard Therapeutic Classes (STCs) for members age 22 and older. Additional information is available on the Medi-Cal Rx
Reinstatement Spotlight. This is the second in a series of lifts to retire or phase out the grandfathering of historical prior authorizations (PAs) and claims. More information is available in the
Medi-Cal Rx 30-Day Countdown - Phase III, Lift 2 communication.
Join Our Team
DHCS is hiring! DHCS has immediate openings for
Information Officer I/II positions who will help DHCS keep the public informed about policy changes, program activities and departmental objectives.
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 healthier, happier lives.
Upcoming Stakeholder Meetings and Webinars
California Advancing and Innovating Medi-Cal (CalAIM): Workgroup Meeting for Managed Long-Term Services and Supports (MLTSS)
On April 19, from 10:30 a.m. to 12 p.m., DHCS will virtually host the
CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). Agenda topics will include updates on the continuous coverage requirement unwinding and the 2024 Medicare Medi-Cal Plan expansion counties, an overview of stakeholder and health plan feedback on the 2024 State Medicaid Agency Contract templates, and an overview of palliative care policy guidance for Dual Eligible Special Needs Plans.
Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the
CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at
info@calduals.org.
Population Health Management (PHM) Advisory Group Meeting
On April 26, from 12:30 to 2 p.m., DHCS will host the next
PHM Advisory Group meeting (advance registration required). The meeting will provide feedback on DHCS' proposed changes to the population needs assessment (PNA) that Medi-Cal MCPs are required to complete. DHCS envisions the modified PNA to promote greater alignment with local health departments and other community stakeholders, more robust community engagement, and a deeper understanding of member health, and social needs, and preferences from the communities in which they live. Stakeholders are encouraged to submit questions before the webinar to
CalAIM@dhcs.ca.gov.
PATH Justice-Involved Round 3 Informational Session
On May 2, from 3 to 4 p.m., DHCS will hold an
informational webinar (advance registration required) to provide application support for interested entities ahead of the July 30 application deadline for PATH Justice-Involved Initiative Round 3 funding. The meeting invite and additional details will be available on the
Justice-Involved Capacity Building Program website. For questions, please contact
justice-involved@ca-path.com.
In Case You Missed It
California's Reproductive Health Access Section 1115 Demonstration (CalRHAD)
On March 16, DHCS launched 30-day public and tribal public comment periods to solicit feedback on a proposed CalRHAD Medicaid Section 1115 demonstration; comments are due by April 17. DHCS is seeking approval from the Centers for Medicare & Medicaid Services 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 about the CalRHAD application and how to submit public comments are available on the
CalRHAD webpage.
Published COVID-19 Information
