Principales noticias 

DHCS lanza la iniciativa de la hoja de ruta de equidad en salud

DHCS publicly launched the Health Equity Roadmap initiative, an ongoing effort to inform and advance DHCS’ work to eliminate health disparities and advance health equity for Medi-Cal members. The Health Equity Roadmap initiative represents a phased process co-designed with Medi-Cal members to create a more equitable Medi-Cal system that puts member needs first. The first step in this process was a statewide listening tour, during which DHCS leaders and community partners listened to Medi-Cal members’ experiences with Medi-Cal. The information gathered from these sessions will inform the development of the DHCS Health Equity Roadmap that will guide the development and implementation of future DHCS programs to advance health equity. 

After the listening sessions, DHCS will begin to identify common themes heard from members throughout the state. DHCS will work closely with Medi-Cal members, experts, advocates, providers, and stakeholders to ensure all relevant voices and experiences are included in the conversation. The Health Equity Roadmap, developed during the co-design phase, will incorporate the ideas and suggestions members shared with us to transform Medi-Cal into a more equitable health care delivery system. 

For inquiries related to the Health Equity Roadmap initiative, or for ideas on how DHCS can make Medi-Cal more equitable, please email HealthEquityRoadmap@dhcs.ca.gov.

Telesalud: Panel de control e informe interactivos de utilización

As part of an overall initiative aimed at monitoring telehealth utilization within Medi-Cal, DHCS released the first phase of its public-facing interactive Medi-Cal Telehealth Utilization Dashboard and companion Biennial Telehealth Utilization Report. Both the dashboard and report will help DHCS take a data-driven approach to evaluating telehealth policy. DHCS’ objective is to consistently provide a range of telehealth metrics and articulate telehealth data in a public-facing format that is easy to access and understand. 

DHCS anticipates publishing the dashboard and report in two phases. Phase one includes eight measure sets of medical services data related to telehealth utilization. Phase two will expand the dashboard to include data sets related to mental health, the Drug Medi-Cal Organized Delivery System, and dental care. The dashboard is anticipated to be completed with all data sets in summer 2024 and will be updated annually thereafter. 

To complement the dashboard, DHCS created the report, which provides an executive summary of Medi-Cal telehealth utilization, trends, and key takeaways. The report includes telehealth utilization data from 2019 to 2022. For more information, please visit the Medi-Cal & Telehealth webpage. Please email your questions to Medi-Cal_telehealth@dhcs.ca.gov.

Program Actualizaciones 

Transición del Programa de Salud Infantil y Prevención de Discapacidades (CHDP)

El Proyecto de Ley del Senado 184 (Capítulo 47, Estatutos de 2022) autorizó al DHCS a eliminar gradualmente el programa CHDP y los servicios de transición a otros sistemas de prestación de Medi-Cal para el 1de julio de 2024. Esta transición simplifica y agiliza la prestación de servicios a niños y jóvenes menores de 21 años, en consonancia con los objetivos de la iniciativa California Advancing and Innovating Medi-Cal (CalAIM). CalAIM aumenta la estandarización de la atención en todo Medi-Cal al consolidar las responsabilidades de cuidado para niños y jóvenes bajo los planes de atención administrada (MCP) de Medi-Cal. 

El Plan de Transición del CHDP se desarrolló en colaboración con el Grupo de Trabajo de Transición del Programa del CHDP y con los comentarios de las partes interesadas del CHDP en todo el estado. La transición preserva la inscripción de elegibilidad presunta que actualmente se ofrece a través de CHDP Gateway, las actividades bajo el Programa de Prevención de Envenenamiento por Plomo Infantil de CHDP y el Programa de Atención Médica para Niños en Cuidado de Crianza. De acuerdo con la sección 124024 del Código de Salud y Seguridad, el DHCS publicó en su sitio web una declaración que certifica que todas las actividades necesarias para una transición exitosa se completaron para el 27de marzo de 2024. 

Medi-Cal Rx

El 29 de marzo se publicó un boletín de cuenta atrás de 30 días para el Requisito de Diagnóstico Código 1 – Rechazar el Código 80 de gestión de utilización de solicitudes (UM) edita la implementación para afiliadas a 22 años o más. A partir del 30 abril de 2024, Medi-Cal Rx empleará el/los código(s) de diagnóstico del historial médico de Medi-Cal del miembro para cumplir con la restricción de diagnóstico del Código I. Si no se encuentra un código de diagnóstico aceptable en el historial médico o no se incluye al momento de la adjudicación de la reclamación, las reclamaciones presentadas a Medi-Cal Rx serán denegadas con el código de rechazo 80. Los requisitos de documentación de recetas se aplican a los medicamentos con diagnóstico restringido de código I. Los prescriptores y proveedores de farmacia deben documentar el diagnóstico del tratamiento y mantener esa información fácilmente disponible para fines de auditoría.

Únete a nuestro equipo 

DHCS is hiring for communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.

Próximas reuniones de partes interesadas y seminarios web 

CalAIM Proporcionando Acceso y Transformando la Salud (PATH) Mercado de Asistencia Técnica (TA)

On April 9 and 25, from 9 to 10:30 a.m., DHCS will host virtual CalAIM PATH TA Marketplace Vendor Fairs, where vendors pitch their organization and services to potential TA Recipients and encourage utilization of the TA Marketplace. Approved TA Recipients and organizations currently contracted with or planning to contract with a Medi-Cal MCP or other eligible entity to provide Enhanced Care Management (ECM)/Community Supports are encouraged to attend. The PATH TA Marketplace is a one-stop-shop website where entities can access free TA services from curated and approved vendors. Vendor services help eligible ECM/Community Supports providers build their data capacity, strengthen cross-sector partnerships, train existing and new staff, implement linguistically responsive services, and more. 

The April 9 Vendor Fair features vendors providing services in Domain 2: Community Supports and Domain 7: Workforce. Domain 2 includes TA vendors with expertise in designing, implementing, and improving one or more Medi-Cal Community Supports services. Domain 7 includes TA vendors with expertise in recruiting and retaining a well-prepared, high-performing workforce, with a particular focus on members of the frontline, clinical, and/or “lived experience” workforces.  

The April 25 Vendor Fair features vendors providing services in Domain 5: Promoting Health Equity and Domain 6: Supporting Cross-Sector Partnerships. Domain 5 includes TA vendors with expertise to help TA recipients advance health equity through their implementation of ECM/Community Supports and in their work with Medi-Cal members. Domain 6 includes TA vendors with the expertise to help TA recipients successfully engage in cross-sector partnerships, including partnerships between Medi-Cal MCPs and counties. 

Additionally, on April 1, DHCS opened the CalAIM PATH TA Marketplace Round 4 vendor application. Organizations interested in applying to qualify as a TA vendor can apply on the PATH TA Marketplace webpage. Applications must be submitted by 5 p.m. PDT on April 30. Approved vendors will receive PATH-funded reimbursements for TA services they provide in the TA Marketplace. For more information, please review the guidance document. 

California Children’s Services (CCS) Advisory Group Meeting

El 10 de abril, de 1 a 4 p.m., el DHCS será el anfitrión de la reunión trimestral del Grupo Asesor de CCS. El Grupo Asesor de CCS y el DHCS trabajan en asociación para garantizar que los niños en el programa CCS y el Modelo del Niño Integral (WCM) reciban acceso adecuado y oportuno a atención de calidad. Los temas de la agenda incluyen actualizaciones sobre el monitoreo y la expansión posterior a la transición de WCM, el Grupo de Trabajo de Cumplimiento, Monitoreo y Supervisión de CCS, el programa de Salud Infantil y Prevención de Discapacidades y el Subcomité de Calidad de la Medida de Desempeño de Rediseño de CCS. Información adicional está disponible en la página web del Grupo Asesor de CCS . Envíe sus preguntas por correo electrónico a CCSProgram@dhcs.ca.gov. 

Reunión del Grupo de Trabajo de Implementación de Partes Interesadas de Doula

El 12 de abril, de 10:00 a 12:00, el DHCS organizará la próxima reunión del Grupo de Trabajo de Implementación de Partes Interesadas en Doulas para examinar la implementación del beneficio de doula de Medi-Cal, de conformidad con el Proyecto de Ley del Senado 65 y la sección 14132.24 del Código de Bienestar e Instituciones. La reunión se llevará a cabo a través de Zoom, con la opción de asistir en persona en 1501 Capitol Avenue, Sacramento, CA 95814, Sala 71.4003. El enlace para asistir a la reunión virtualmente, junto con el programa, están disponibles en la sitio web de Servicios de Doula como Beneficio de Medi-Cal. Por favor, envía tus preguntas por correo electrónico a DoulaBenefit@dhcs.ca.gov.

Por si te lo perdiste 

DHCS publica un informe trimestral de implementación sobre ECM y apoyos comunitarios

On April 4, DHCS released the latest ECM and Community Supports Quarterly Implementation Report that includes data from January 2022 through September 2023. This data release adds third quarter 2023 utilization data at the state, county, and Medi-Cal MCP levels and demographics, including ethnicity, primary language spoken, age, and sex. 

The data report demonstrates the uptick in both the availability and use of Community Supports, showing significant growth in the number of counties offering these services. As of January 2024, 23 counties across California offered all 14 Community Supports, and all counties offered at least seven Community Supports. This marks a significant increase from the end of 2022, when only three counties offered all 14 Community Supports. Overall, approximately 103,000 unique Medi-Cal members used Community Supports in the first 21 months of the program, with more than 186,000 total services delivered. Additionally, the number of members served by ECM each quarter is up; in Q3 2023, approximately 86,000 members received ECM, up 28 percent from Q4 2022. The Q3 2023 total includes 6,300 members under age 21, many of whom were newly eligible for ECM in July 2023. Altogether, more than 160,000 unique Medi-Cal members across the state received ECM in the first 21 months of the benefit. 

ECM and Community Supports aim to improve Medi-Cal members’ overall health and well-being by addressing both medical and social factors that can impact a person’s health, including housing assistance, meal programs, job training, and centralized coordination of care. For inquiries related to the report or to provide feedback on the data, please email CalAIMECMILOS@dhcs.ca.gov. 

Recorrido móvil en camioneta dental de Medi-Cal

On April 4, DHCS kicked off the second mobile dental van tour in Fresno with a press event. DHCS’ Smile, California campaign informs Medi-Cal members about preventive dental services to children and youth to enhance utilization of essential dental care and improve oral health, particularly for underserved groups. In addition to Fresno, the mobile dental van visited Pixley (April 5) and will make future stops in Hollister (April 11), Avenal (April 12), and Huntington Park (May 4). 

Los afiliados a Medi-Cal, los proveedores médicos y dentales y las organizaciones comunitarias pueden obtener más información sobre los servicios dentales cubiertos por Medi-Cal visitando el sitio web de Smile, California, en inglés en SmileCalifornia.org o en español en SmileCalifornia.org. El sitio web incluye recursos útiles, como folletos informativos, videos, fichas informativas y la herramienta "Find-A-Dentist" para localizar un proveedor dental.