DHCS Stakeholder News - May 12, 2023
Top News
Governor's May Revision
Governor Gavin Newsom proposed a
$156 billion May Revision for DHCS programs and services for fiscal year 2023-24. It proposes to support vital services that reinforce the state's commitment to preserve and improve the overall health and well-being of all Californians while operating within a responsible budgetary structure. Highlights include:
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Managed Care Organization (MCO) Tax and Medi-Cal Provider Rate increases. The May Revision includes the renewal of the
MCO tax, effective April 1, 2023, nine months earlier than planned at Governor's Budget. This earlier start results in approximately $3.7 billion in additional General Fund for calendar year 2023. Additionally, the May Revision increases MCO revenue (as compared to Governor's Budget) to achieve an approximately $5 billion annual state benefit.
- A portion of this revenue will support an increase in provider rates to at least 87.5 percent of Medicare for specified providers, including Primary Care (inclusive of nurse practitioners and physician assistants), Maternity Care (inclusive of OB/GYN and doulas), and non-specialty mental health services beginning January 1, 2024.
- Additionally, in collaboration with key stakeholders in the Medi-Cal delivery system and with a focus on enhancing equitable access to care, DHCS will assess which ongoing, long-term rate augmentations will deliver the greatest benefit to improving Medi-Cal systems across California. The focus will be to look at additional augmentations to primary care, maternal care, and behavioral health as well as specialty care, outpatient, and acute care systems with attention on how to increase the commitment of providers to serve Medi-Cal members, support providers in disproportionately impacted areas, and build robust teams and programs with a strong workforce, to ensure care is provided in the right settings, at the right time, and at the highest quality. Following this process, DHCS will return with a proposed set of investments and augmentations that will be put forward to the Legislature in the 2024-25 Governor's Budget, with an intended effective date of January 1, 2025.
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Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT). Formerly known as California Behavioral Health Community-Based Continuum (CalBH-CBC), the proposal continues to include the 1115 demonstration waiver to address the gaps in the behavioral health continuum of care for Medi-Cal members living with serious mental illness (SMI) and serious emotional disturbance (SED). The May Revision adds a new Workforce Initiative to the waiver, $480 million a year for the five years ($2.4 billion total funding), to strengthen the pipeline of behavioral health professionals, including improving short-term recruitment and retention efforts.
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Behavioral Health Modernization. The May Revision includes initial funding to support the
behavioral health modernization proposal.
May Revision Budget Documents:
DHCS Announces New Name for Behavioral Health Waiver
DHCS is renaming the proposed California Behavioral Health Community-Based Continuum (CalBH-CBC) demonstration waiver to better align with the Department's mission, vision, and goals. It will now be known as the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) waiver. The name change emphasizes DHCS' commitment to providing a robust continuum of community-based behavioral health care services and improving equity, quality, and access for all Medi-Cal members living with SMI and SED, particularly populations experiencing disparities in behavioral health access and outcomes. The waiver name is new, but its objectives and approach remain the same.
The waiver is informed by findings from DHCS' 2022 report,
Assessing the Continuum of Care for Behavioral Health Services in California, and is a historic opportunity to make significant investments in the full continuum of care for behavioral health, with a particular focus on the most vulnerable populations. For more information about this waiver, please visit the
DHCS website.
Program Updates
Concept Paper on Updated Population Needs Assessment (PNA)
DHCS released a
concept paper that outlines DHCS' vision of a reimagined PNA that Medi-Cal managed care plans (MCPs) are required to complete. DHCS envisions a modified PNA that promotes 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 and the communities in which they live. This approach will help target resources and interventions to support improved health outcomes for Medi-Cal members. DHCS encourages feedback on the concept paper through written comments and by participating in upcoming public forums and advisory groups. DHCS will accept public comment through 5 p.m. on June 2, 2023, to
PHMSection@dhcs.ca.gov, with the subject line “Comments on PNA Concept Paper".
Along with the concept paper, DHCS will soon issue a new All Plan Letter (APL) to replace
APL 19-011 and provide near-term MCP guidance on the modified PNA and the new population health management strategy. For more information and regular updates, please visit the
CalAIM Population Health Management Initiative webpage.
Health Enrollment Navigators Project
On May 12, DHCS notified partners who applied for the remaining unallocated Health Enrollment Navigator funding of $3.6 million appropriated through Assembly Bill 74 (Chapter 23, Statutes of 2019) and Senate Bill 154 (Chapter 43, Statutes of 2022). These additional funds will immediately enable partners to establish new, and augment existing, activities and events related to Medi-Cal expansions and Medi-Cal renewal during the continuous coverage unwinding period. Local community-based organizations interested in assisting with these efforts can refer to the
Project Partner Contact Information on the
Project Partners section of the DHCS website.
Medi-Cal Rx Update
On May 19,
Phase III, Lift 3 will be implemented, lifting the Transition Policy for 22 Standard Therapeutic Classes. This is the third in a series of lifts to phase out the grandfathering of historical prior authorizations and claims by reinstating Reject Code 75 – Prior Authorization Required.
Smile, California Campaign for Medi-Cal Dental Services
During the week of May 22, a monthly Smile Alert e-newsletter will be sent to all subscribers serving as a reminder for Medi-Cal members to take the 2023 Member Customer Service survey. The newsletter will also call attention to the
common questions page on
SmileCalifornia.org, where Medi-Cal members can access common questions about Medi-Cal dental coverage.
Family PACT Annual Program Report
On May 12, DHCS
posted the Family Planning, Access, Care and Treatment (Family PACT) Program Fiscal Year 2019-20 Report on the
Family PACT website.
The statute requires an annual analysis of key program metrics. This annual report is based on enrollment and claims data that describe Family PACT provider and client populations, types of services utilized, and program reimbursement. Dates of service in this report are for fiscal year 2019-20, which began on July 1, 2019, and ended on June 30, 2020.
Join Our Team
DHCS is hiring! DHCS has an immediate opening for
Deputy Director and Chief Counsel, Office of Legal Services. This executive role offers the right attorney an opportunity to lead DHCS' legal team in providing comprehensive legal and regulatory services and advice regarding Medi-Cal and behavioral health.
DHCS is also hiring for our fiscal, human resources, legal, auditing, health policy, communications, 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
Dementia Care Aware – Cognitive Health Assessment (CHA) Virtual Training
Starting May 19, 2023, Dementia Care Aware is offering monthly
Zoom trainings (advance registration required) on the CHA, led by geriatric medicine experts at the University of California, Irvine. The CHA is a dementia screening approach intended to be conducted in older adult patients whenever a cognitive screen is indicated. Primary care providers and teams should join the training on May 19, and the first and third Fridays of each month thereafter, to learn more about how this assessment can empower primary care providers and their teams to better detect dementia in their patients. Free continuing medical education and continuing education units are available.
Updated Requirements and Procedures for Enrollment of Medi-Cal Dental Providers
On May 22, from 1:30 to 3 p.m., DHCS will hold a
public hearing via webinar (advance registration required) to discuss the regulatory provider bulletin entitled,
“Updated Requirements and Procedures for the Enrollment of Medi-Cal Dental Providers." Stakeholders can submit questions and suggestions during the hearing, and written comments will be accepted on the day of the hearing. Based on the public comments received, DHCS will publish the final bulletins on the
Medi-Cal and
DHCS websites. The changes will become effective 30 days after publication.
For those who are unable to attend, written comments to be considered prior to publication may be submitted by 5 p.m. on May 22 to
DHCSPEDStakeholder@dhcs.ca.gov. Please ensure the commenter and organization/association represented are identified in the comment.
Stakeholder Advisory Committee (SAC) and Behavioral Health Stakeholder Advisory Committee (BH-SAC) Meeting
On May 24, from 9:30 a.m. to 3:30 p.m., DHCS will host the
second SAC and BH-SAC hybrid meeting of 2023 (advance registration required). It will open as a joint meeting, with topics shared by SAC and BH-SAC. There will be a BH-SAC-only meeting held after the joint meeting; there is no SAC-only meeting. Attendees can attend in person at The California Endowment, located at 1414 K Street in downtown Sacramento, or virtually. For more information, please visit the
SAC and
BH-SAC webpages.
Fee Schedule Workgroup
On May 25, from 1 to 3 p.m., DHCS, in collaboration with the Department of Managed Health Care (DMHC), will virtually host the
fourth public workgroup meeting (advance registration required) to discuss the development of the statewide all-payer fee schedule for school-based behavioral health services under the Children and Youth Behavioral Health Initiative. DHCS and DMHC will engage partners representing K-12 education, institutions of higher education, Medi-Cal MCPs, commercial health plans, county behavioral health departments, behavioral health providers, associations, advocates, youth, and parents/caregivers on a variety of policy and operational topics to inform the development and refinement of the program design.
In Case You Missed It
DHCS Director Michelle Baass' Message on the End of the COVID-19 Public Health Emergency (PHE)
DHCS expresses gratitude to our plans, providers, stakeholders, and other partners for their commitment and partnership during the COVID-19 PHE. We worked together and adapted quickly to the pandemic's challenges and difficulties to care for millions of Californians. Our joint efforts enabled us to navigate the PHE with resilience and perseverance, and we are grateful for your ongoing engagement. Read the full statement.
New Lifesaving Tools and Resources for Substance Use Disorder Prevention, Treatment, and Recovery
On May 11, DHCS launched a partnership with national nonprofit Shatterproof to help combat the substance use crisis, keep Californians safe, and provide recovery resources to those in need. The new resources include
Treatment Atlas, a confidential addiction treatment locator, assessment, and standards website platform that connects individuals and their families to appropriate evidence-based, high-quality addiction treatment. Additionally, to empower individuals and change attitudes about substance use disorders, DHCS launched
Unshame California, a science-driven and content-based campaign that promotes anti-stigma messaging through stories of Californians impacted by substance use disorders. Both of these resources are available in English and Spanish.
Published COVID-19 Information
