1de abril de 2025
Principales noticias
DHCS publica el último informe trimestral sobre la gestión mejorada de la atención y el apoyo a la comunidad
On March 27, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report summarizing utilization data from July 2024 through September 2024. Key highlights from the report include:
- Crecimiento constante: Desde el lanzamiento de ECM en enero de 2022, 279,824 miembros únicos de Medi-Cal se han inscrito con éxito en los beneficios de ECM. Solo en el tercer trimestre de 2024, 143.188 miembros únicos accedieron a los beneficios de ECM, lo que supone un aumento del 13% con respecto al segundo trimestre de 2024.
- Participación juvenil: En el tercer trimestre de 2024, 28,342 niños y jóvenes menores de 21 años accedieron a los beneficios de ECM, lo que representa un aumento del 13 por ciento con respecto al segundo trimestre de 2024.
- Uso de Apoyos Comunitarios: Aproximadamente 296,500 miembros únicos de Medi-Cal han utilizado Apoyos Comunitarios, con más de 754,000 servicios totales prestados. Solo en el tercer trimestre de 2024, 136.031 miembros únicos recibieron apoyo de la comunidad, lo que supone un aumento del 7,5% con respecto al segundo trimestre de 2024.
- Mayor acceso a los servicios: Para el tercer trimestre de 2024, casi el 90 por ciento de los miembros de Medi-Cal tenían acceso a al menos 10 de los 14 servicios de Apoyo Comunitario. Más del 41 por ciento de los miembros tienen acceso al conjunto completo de servicios.
- Servicios clave utilizados: Más del 61 por ciento de los miembros que utilizaron los Apoyos Comunitarios accedieron a Comidas Médicamente Personalizadas/Alimentos de Apoyo Médico, y aproximadamente el 32 por ciento utilizaron uno o más servicios del Trío de Vivienda (Servicios de Navegación de Transición de Vivienda, Servicios de Arrendamiento y Sostenimiento de Vivienda, y Depósitos de Vivienda).
Este último informe de implementación de ECM y Apoyos Comunitarios muestra un aumento sostenido en la utilización trimestre tras trimestre a medida que las poblaciones adicionales de enfoque se han vuelto elegibles para ECM y se ofrecen servicios adicionales de Apoyo Comunitario en condados de todo el estado. DHCS espera ver un mayor crecimiento de la matrícula en ECM y Community Supports en los próximos meses y años. En 2025, DHCS continuará apoyando y sosteniendo este crecimiento a través de esfuerzos ampliados de monitoreo del programa ECM y Community Supports, una sólida participación de las partes interesadas y refinamientos en el diseño de políticas.
Program Actualizaciones
Trabajadores de Salud Comunitarios
Effective April 1, DHCS updated Medi-Cal’s existing Community Health Worker (CHW) policy to allow supervising Medi-Cal providers to bill for covered CHW services provided by CHWs using two new Healthcare Common Procedure Coding System (HCPCS) codes recently added by the Centers for Medicare & Medicaid Services (CMS). DHCS is updating this policy to allow CHWs to better address the economic and social conditions that influence Medi-Cal members and community health, such as food, housing, and transportation insecurities and access to essential utilities. DHCS’ updated CHW policy aims to more effectively support and promote improved health outcomes for Medi-Cal members by addressing needs affected by social drivers of health. DHCS also issued a State Plan Amendment Public Notice to set the rates for these two codes to 100 percent of the Medicare rate, pursuant to Welfare & Institutions Code Section 14105.25.
Additionally, on April 1, DHCS issued a statewide standing recommendation that all Medi-Cal members who meet defined eligibility criteria for receiving CHW services would benefit from CHW services. This standing recommendation, issued to improve access and reduce barriers to Medi-Cal members receiving and Medi-Cal providers rendering CHW services, is signed by Dr. Karen Mark, DHCS’ Medical Director for Policy and Evaluation. Consistent with existing policy, this standing recommendation authorizes CHWs to provide covered Medi-Cal CHW services, including health education, health navigation, screening and assessment, and individual support and advocacy.
Únete a nuestro equipo
DHCS está buscando una persona talentosa y motivada para servir como:
- Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state’s Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.
DHCS también está contratando para sus equipos, auditorías, atención gestionada, gestión de la salud poblacional y otros equipos. Para más información, por favor visite el sitio web de CalCareers.
Próximas reuniones de partes interesadas y seminarios web
DHCS posts upcoming public meetings on the Calendar of Events.
Seminario web para socios de Strong Start & Beyond
On April 2, from 12 to 12:45 p.m. PDT, California Surgeon General Dr. Diana E. Ramos will host the next Strong Start & Beyond partner webinar on prevention to improve lifelong health. Strong Start & Beyond is a bold movement to reduce California’s maternal mortality rate by 50 percent by December 2026. By leveraging the state’s investments and partnerships, we can foster awareness, encourage active participation in health, and build access to resources for mothers, pregnant people, and their families. Joining Dr. Ramos are Dr. Erica Pan, California Department of Public Health Director and State Public Health Officer; Dr. Bernadette Lim, Founder and Executive Director of the Freedom Community Clinic; and Dr. Atul Nakhasi, Transformational Physician Executive. Please contact the Office of the California Surgeon General if you have any questions.
Grupo de Trabajo de Partes Interesadas Centrado en el Consumidor (CFSW)
On April 4, from 10 to 11:30 a.m. PDT, DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted by April 2 on the DHCS Consumer-Focused Stakeholder Workgroup webpage.
California Children’s Services (CCS) Advisory Group Meeting
On April 9, from 1 to 4 p.m. PDT, DHCS will host the CCS Advisory Group quarterly meeting (advance registration required). DHCS and the CCS Advisory Group partner to ensure children in the CCS/Whole Child Model (WCM) program receive appropriate and timely access to quality care. Agenda topics include updates on 2025 priorities, including the 2025 WCM expansion; county compliance, monitoring and oversight; and Medi-Cal Rx pediatric integration. Additional information and meeting details are available on the CCS Advisory Group webpage.
Grupo de Trabajo de Partes Interesadas en la Implementación de Doula
On April 11, from 10 a.m. to 12 p.m. PDT, DHCS will host the next Doula Implementation Stakeholder Workgroup meeting, as required by Senate Bill 65 (Statutes of 2021, Chapter 449), to examine the implementation of the Medi-Cal doula benefit, in accordance with section 14132.24 of the Welfare and Institutions Code. The meeting will be held at 1501 Capitol Avenue, Sacramento, CA, and is open to the public. The link for this meeting will be available on the DHCS Doula Implementation Stakeholder Workgroup webpage. The workgroup will discuss ways to minimize barriers to doula services and continue discussions regarding the workgroup’s report to the Legislature, which must be posted on DHCS’ website by July 1, 2025.
Ley de Protección del Acceso a la Atención Médica (PAHCA)-Comité Asesor de Partes Interesadas (SAC)
On April 14, from 11:30 a.m. to 3:30 p.m. PDT, DHCS will host the PAHCA-SAC meeting (advance registration for online participation required) at 1700 K Street (first-floor conference room 17.1014), Sacramento. The committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). For general inquiries or to receive more information about meetings, please email DHCSPAHCA@dhcs.ca.gov.
Implementación de Beneficios de Prácticas Tradicionales de Cuidado de la Salud
On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Med-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.
Por si te lo perdiste
DHCS anuncia premios para el tratamiento del trastorno por uso de opioides
On March 25, DHCS awarded $800,000 to two Local Emergency Medical Service Agencies to foster low-barrier access to clinically proven opioid use disorder (OUD) treatment for patients in an emergency medical services (EMS) setting who are at risk of overdose and often do not have access to services in other settings. The grants—awarded through the Emergency Medical Services Buprenorphine Use Pilot Program (EMSBUP) to the Stanislaus County EMS Agency and Ventura County EMS Agency—will enable these two agencies to address substance use disorder as a treatable emergency condition, utilizing paramedics to identify and treat patients who would benefit from medications for addiction treatment (MAT). MAT is the use of medications in combination with counseling and behavioral therapies, which is effective in treating OUDs and helping some people sustain recovery.
Ya está abierta: Solicitud de la Ronda 4 para la Transición, Expansión y Desarrollo de la Capacidad y la Infraestructura (CITED) de Proporcionar Acceso y Transformar la Salud (PATH)
On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.
The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PDT on May 2, 2025. The guidance document and application are available on the PATH CITED webpage. Please send any questions to cited@ca-path.com.