فرع مراقبة كفاية شبكة الصحة السلوكية المنزلية​​ 

فرع الرقابة على كفاية شبكة الصحة السلوكية​​ 

ارجع إلى الصفحة الرئيسية لخدمات الصحة السلوكية.​​  

The Behavioral Health Network Adequacy Oversight Branch (BHNAOB) is structurally within the Behavioral Health Oversight and Monitoring Division (BHOMD), which is a part of the Behavioral Health program of the Department of Health Care Services. Information about BHOMD can be found via the Behavioral Health Services homepage link at the top of this document. BHNAOB is responsible for the Medi-Cal Behavioral Health network adequacy program, the Behavioral Health Services Act network adequacy program, and formerly had administrative responsibility for the Behavioral Health Quality Improvement Program (BHQIP), which was sunset on June 30, 2024. The Network Adequacy Oversight Sections are responsible for the oversight and monitoring all behavioral health components of the Specialty Mental Health Services (SMHS) and Drug Medi-Cal Organized Delivery System (DMC-ODS) program, as well as timely access requirements for Drug Medi-Cal state plans due to parity requirements​​ 

قسم مراقبة كفاية الشبكة​​ 

The Network Adequacy Oversight Section (NAOS) is found within the BHNAOB. BHNAOB is found within BHOMD and is a part of the Behavioral Health program of DHCS.​​  

DHCS contracts with counties that either provide, or arrange for the provision of, specialty mental health services and substance use treatment services to eligible Medi-Cal members.​​  

NAOS performs compliance oversight and monitoring of the MHPs and DMC-ODS programs to ensure compliance with the network adequacy requirements set forth in Title 42 of the Code of Federal Regulations (CFR) and the network adequacy requirements of the Behavioral Health Services Act. NAOS primarily assesses the compliance of MHPs and DMC-ODS programs through its reviews of required submissions from these entities as part of an annual network certification process. NAOS, as necessary to ensure the adequacy of each provider network, identifies any deficiencies with current standards, including timely access standards as prescribed by WIC 14197 and provides technical assistance to the MHPs and DMC-ODS programs to resolve compliance issues. Where technical assistance is not effective, NAOS implements corrective measures such as corrective action plans and administrative or monetary sanctions.​​  

NAOS also performs oversight, technical assistance, and monitoring related to improving access to care, which includes timely access requirements as defined in Welfare and Institutions Code 14197. These requirements include an initial request for first appointment or first specialty mental health service for new members, non-urgent follow-up appointments, and ensuring language assistance services are coordinated with scheduled appointments for health care services.​​  

إن أنشطة الامتثال والرصد الخاصة بكفاية الشبكة المحددة هنا خاصة بـ MHPs وبرامج DMC-ODS وخطط ولاية DMC خصيصًا لمتطلبات الوصول في الوقت المناسب. يراقب قسم جودة الرعاية المُدارة والمراقبة متطلبات كفاية الشبكة لخطط الرعاية المُدارة. يرجى الرجوع إلى صفحة الويب الخاصة بكفاية شبكة خدمات الرعاية الصحية للحصول على مزيد من المعلومات المتعلقة بمدى كفاية الشبكة، بما في ذلك تقارير الشهادات السنوية ومعايير الوصول البديلة المعتمدة وخطط العمل التصحيحية.​​  

Provided below are some federal and state laws applicable to NAOS. These laws are found within the CFR, and Welfare and Institutions Code (WIC).​​  

القوانين المعمول بها​​  

فيدرالي:​​  

  • 42 CFR 438.206 توفر الخدمات​​  
  • 42 CFR 438.207 ضمان القدرة والخدمات الكافية​​  
  • 42 CFR 438.68 معايير كفاية الشبكة 42 CFR 438.68​​  

الولاية (النظام الأساسي):​​  

  • القسم 1367.03 من قانون النظام المنسق 1367.03​​  
  • قسم WIC 14197​​  

الولاية (اللوائح):​​  

  • 28 CCR القسم 1300.67.04 من القانون الجنائي رقم 28 CCR القسم 1300.67.04​​  
  • 28 CCR القسم 1300.67.67.2.2.2​​  

مصادر إضافية​​ 

كاليفورنيا للتقدم والابتكار Medi-Cal (CalAIM):​​ 

برنامج Medicaid وMedi-Cal العام:​​ 

معلومات الاتصال​​