Principales noticias​​ 

Respuesta del DHCS a los incendios forestales en el sur de California​​ 

On January 7 and 8, multiple fires erupted in the Los Angeles County area. DHCS is actively engaged in addressing the impacts of the fires. DHCS is working alongside local and federal partners to support health care facilities, ensure continuity of care, and prioritize the safety of affected residents. Specifically, DHCS is coordinating with facilities to manage evacuations and maintain care for residents and is supporting health care providers as they navigate road closures and other disruptions.​​ 

DHCS’ Emergency and Disaster Assistance Questions & Answers webpage provides guidance and contact information for Medi-Cal members and providers during emergencies. It includes information related to accessing medical care, filling prescriptions, securing transportation, and obtaining support for individuals with specific needs, including people in assisted living facilities and individuals receiving Home and Community-Based Alternatives services.​​ 

La Oficina de Servicios de Emergencia del Gobernador de California y el Departamento de Rehabilitación desarrollaron una Guía/Kit de Herramientas para Emergencias para Personas con Discapacidad, disponible en varios idiomas que incluye información y consejos para emergencias para personas con discapacidades específicas. Sigue a Cal Fire y a las autoridades locales de emergencias para recibir actualizaciones en tiempo real sobre los incendios forestales, y suscríbete para recibir alertas locales en calalerts.org. Por favor, consulte los siguientes recursos adicionales para más información:​​ 

• CA.gov/LAFIRES – Proporciona recursos a los californianos afectados por los incendios forestales Los Angeles .​​ 
• Listos California – Ofrece una página de registro de Alertas de Emergencia para ayudar a conectar a los californianos con sus sistemas locales de alertas según el código postal o la ubicación proporcionada.​​ 
• Ready.Gov – Provides guidance for individuals and families to prepare for, respond to, and recover from wildfire events. The resource includes tips for staying safe during wildfires and returning home once an area is declared safe.​​ 
• Recursos de Incendios Forestales de la Administración de Servicios de Abuso de Sustancias y Salud Mental – Apoya a supervivientes, familiares, equipos de emergencia y trabajadores de recuperación afectados por incendios forestales y otros desastres. La información incluye signos de angustia emocional, poblaciones que pueden estar en mayor riesgo de sufrir sufrimiento tras un incendio forestal y enlaces a recursos para obtener más información y apoyo.​​ 
• Centros para el Control y la Prevención de Enfermedades – Proporciona información sobre peligros, incluidos incendios forestales, y ofrece enlaces a información sobre cómo mantener seguro tras un incendio forestal y aprender y afrontar los peligros relacionados con incendios y otros desastres.​​ 
• American Red Cross – Suggests ways for people who have experienced a residential fire to take care of themselves and their loved ones and to help people who may need assistance. The site lists four steps to take right after a fire and includes links to more information about returning home safely after a fire and recovering emotionally and financially.
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DHCS mantiene su compromiso de apoyar a las comunidades durante estos tiempos difíciles y agradece a los servicios de emergencia y a los trabajadores de la salud en el terreno. Manténgase a salvo, consulte las actualizaciones oficiales para obtener la información más reciente y siga las órdenes de evacuación emitidas por los funcionarios locales.​​ 

Propuesta de presupuesto del DHCS para 2025-26​​ 

The proposed 2025-26 Governor’s Budget for DHCS allocates $193.4 billion in total funds, including $42.8 billion from the General Fund, and supports 4,821.5 positions. This budget reflects the Administration’s continued investment in transforming Medi-Cal into a coordinated, person-centered, and equitable health system for Californians.​​ 

The budget prioritizes modernizing the health care delivery system, with a focus on improving accountability and transparency and strengthening community-based care. These strategic investments support DHCS’ purpose to provide equitable access to quality health care, leading to a healthy California for all.​​ 

Program Actualizaciones​​ 

Se aprueba la enmienda del plan estatal (SPA) para los servicios diádicos​​ 

On January 6, the federal Centers for Medicare & Medicaid Services (CMS) approved SPA #23-0010, which authorizes DHCS to utilize an Alternative Payment Methodology (APM) to pay Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs, which includes Tribal FQHCs and Indian Health Services-Memorandum of Understanding 638 Clinics, at the Medi-Cal fee-for-service (FFS) rate for dyadic services in certain circumstances. FQHCs and RHCs will receive a separate payment for dyadic services in addition to their standard Prospective Payment Services/All-Inclusive Rate billing payments in certain circumstances.​​ 

Dyadic care refers to serving both the parent/caregiver and child together as a dyad and is a form of treatment that targets family well-being to support healthy child development and mental health. Dyadic care fosters team-based approaches to meeting family needs, including addressing mental health and social support concerns, and it broadens and improves the delivery of pediatric preventive care. Offering parents and caregivers mental health services when they bring their babies and children to the doctor is an opportunity to expand access, which can improve outcomes. DHCS will release additional policy guidance in a future Medi-Cal Provider Manual update.​​ 

Transición al nuevo portal Family PACT​​ 

From January 13 through February 2, DHCS’ Family Planning, Access, Care and Treatment (PACT) program’s client eligibility and enrollment transaction services will transition from the Health Access Programs (HAP) Client Eligibility System to a new Family PACT portal. The HAP Client Eligibility System will be disabled on February 3, after which all Family PACT client enrollment, changes, and deactivations will be completed exclusively through the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Family PACT portal. To support Family PACT providers during this transition, Family PACT providers will have access to comprehensive training materials and webinars through the Family PACT Online Training Center Learning Management System. These resources will ensure that providers are equipped to use the Family PACT portal effectively before its launch.​​ 

Ajuste de la póliza para la integración pediátrica (PI) de Medi-Cal Rx​​ 

DHCS is making an important policy adjustment related to Medi-Cal Rx’s initiative for the reinstatement of prior authorization (PA) requirements and utilization management (UM) claim edits for Medi-Cal members 21 years of age and younger, including members of the California Children’s Services (CCS) program. This initiative, commonly referred to as PI, will be implemented on January 31. To directly address and help mitigate stakeholder concerns about the volume of PA requests and potential barriers to timely access that may occur because of PI implementation, as well as recognize the advanced credentialing of CCS Panel Provider Authority, DHCS is adjusting its PI policy approach for continuing therapies/prescriptions PI as follows:​​ 

• Por un período de no menos de 60 días, si una reclamación sería rechazada con el Código de Rechazo 75 (se requiere PA), pero el miembro de Medi-Cal tiene un historial de reclamaciones reciente, la reclamación se pagará sin necesidad de PA adicional. DHCS tiene la intención de que este enfoque brinde a los proveedores y prescriptores tiempo adicional para ajustar sus procesos internos y planificar mejor los requisitos de PI y presentar PA proactivas.​​ 

DHCS will release additional, more detailed information through the Medi-Cal Rx website and will update various existing resource documents on a flow basis. DHCS remains committed to ensuring Medi-Cal members, providers, and other partners are supported so pharmacy benefits can be accessed in a safe, timely, and equitable manner. DHCS will continue to support and engage stakeholders on PI.​​ 

Únete a nuestro equipo​​ 

DHCS está buscando una persona talentosa y motivada para servir como:​​ 

• Chief of the Pharmacy Benefits Division. The Chief is responsible for overseeing the development and implementation of policy, services, and coverage criteria for outpatient pharmacy services for the state’s Medi-Cal program. This includes providing policy direction for Medi-Cal Rx as well as invoicing and collecting federal and state supplemental drug rebates. The Chief of PBD also leads the development of nutrition, vision care, and medical supply benefits and oversees the administration of the Medi-Cal Pharmacy and Vision Benefit programs. Applications must be submitted by February 7.​​ 

DHCS is also hiring for its accounting, program accountability, behavioral health, managed care quality and monitoring, eligibility, and other teams. For more information, please visit the CalCareers website.​​ 

Próximas reuniones de partes interesadas y seminarios web​​ 

Seminario web del Comité Asesor de Calidad y Equidad para la Transformación de la Salud Conductual​​ 

On January 15, from 9 to 11 a.m. PST, DHCS will host the third Behavioral Health Transformation Quality and Equity Advisory Committee webinar. Once registered, you will receive a confirmation email with the webinar link and additional details. DHCS is pleased to continue its collaborative efforts to measure and evaluate the quality and efficacy of behavioral health services and programs. These public webinars provide an opportunity for participants to offer input for DHCS consideration. Visit the Behavioral Health Transformation Stakeholder Engagement webpage for more information about the webinars and additional resources. Please send questions related to Behavioral Health Transformation and/or the webinars to BHTinfo@dhcs.ca.gov.​​ 

Smile, California Seminario sitio web: Promoción del beneficio dental de Medi-Cal para el Mes Nacional de la Salud Dental Infantil​​ 

On January 22, from 11 a.m. to 12 p.m. PST, Smile, California will host a webinar to kick off National Children’s Dental Health Month (NCDHM) in February. The webinar will feature a preview of the new Healthy Smile Land materials, strategies for promoting Medi-Cal dental services during NCDHM, and resources for accessing and distributing outreach materials. Attendees will also be able to connect with Smile, California representatives to ask about Medi-Cal dental benefits.​​ 

Cumbres de Reducción de Daños del DHCS​​ 

DHCS collaborates with communities across the state to promote harm reduction and low-barrier, patient-centered care within California’s substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno County (January 23), San Diego County (February 11), and Los Angeles County (February 27). Register on the event website.​​ 

Serie de seminarios web de Embajadores de Cobertura: Iniciativa de Reingreso Involucrado en la Justicia y Actualización de la Iniciativa de Salud Conductual para Niños y Jóvenes​​ 

El 30 de enero, de 11 a 11:45 a.m. PST, DHCS organizará un seminario sitio web para los Embajadores de Cobertura de DHCS (se requiere inscripción previa). El seminario sitio web ofrecerá actualizaciones sobre la Iniciativa de Reinserción Relacionada con la Justicia y la Iniciativa de Salud Conductual de Niños y Jóvenes (CYBHI). Transmitirá información sobre personas implicadas en la justicia que están ahora, o pasaron tiempo, en cárceles, centros penitenciarios juveniles o prisiones y que tienen un mayor riesgo de sufrir malos resultados de salud, lesiones y muerte que el público. Se centrará en pasos significativos que California está dando para mejorar los malos resultados de salud de las personas mientras se preparan para reincorporar a sus comunidades, trabajando para cerciorar la continuidad de la cobertura tras su liberación. Además, los Embajadores de la Cobertura aprenderán cómo se ampliarán los servicios de integración en la primera infancia a través de CYBHI, que proporcionará servicios de salud mental a niños, jóvenes y familias. Descubre más sobre los Embajadores de Cobertura de DHCS, o regístrate para convertirte en Embajador de Cobertura.​​ 

Capacitación en inserción de dispositivos intrauterinos (DIU) e implantes anticonceptivos​​ 

On February 19, from 7:30 a.m. to 5:30 p.m. PST, DHCS’ Office of Family Planning will host an in-person Comprehensive IUD and Contraceptive Implant Insertion Training. The training, which is currently full, includes information about patient method selection, counseling and consent, techniques for using instruments during IUD placement, and instruction on the insertion of each type of IUD currently available in the United States. Additional topics to be covered include management of side effects, tips for managing difficult placements, pain management principles for office procedures, and prevention and management of complications. Please see IUD & Implant Resources for more information.​​ 

Por si te lo perdiste​​ 

CMS selecciona a DHCS para su innovador modelo de transformación de la salud materna​​ 

El 6 de enero, CMS aprobó la participación de Californiaen su Modelo Transforming Maternal Health (TMaH) del Centro para Medicare y Medicaid Innovación, un modelo de Medicaid diez años de entrega y pago del Seguro de Salud Infantil Program (CHIP) diseñado para comprobar si la implementación efectiva de intervenciones informadas por la evidencia, sostenida por un modelo de pago basado en el valor (VBP), puede mejorar los resultados maternos y reducir los gastos Program para Medicaid y CHIP.​​ 

DHCS implementará el Modelo TMaH en cinco condados: Fresno, Kern, Kings, Madera y Tulare. El Modelo TMaH forma parte del compromiso más amplio de California para abordar las disparidades raciales y étnicas en la salud materna y garantizar que todas las personas embarazadas, especialmente las de comunidades de bajos ingresos, reciban el apoyo necesario para afrontar el embarazo y el parto con seguridad.​​ 

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. 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. Nearly $158 million is available for Round 4. The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PST on March 7, 2025. The guidance document and application can be found by visiting the PATH CITED webpage. Please submit questions to cited@ca-path.com.​​ 

Solicitud de proveedor de la ronda 5 del mercado de asistencia técnica (TA) de PATH​​ 

On January 1, DHCS opened the PATH TA Marketplace Round 5 vendor application. The deadline to apply is January 31. Round 5 will be a targeted procurement for new and existing hands-on service offerings that address TA Marketplace gaps. The Round 5 procurement will seek TA vendor applications for all seven TA domains, but it will focus on services for the following provider types: rural providers, Tribal and Indian health care providers, maternal and child-serving providers, and transitional rent providers.​​ 

DHCS no aceptará presentaciones para nuevos proyectos listos para usar o cambios en proyectos existentes durante el período de adquisición de la Ronda 5. En su lugar, la aplicación de la Ronda 5 solicitará recursos bajo demanda de los proveedores de asistencia técnica existentes. Visite la página web de proveedores de TA Marketplace para acceder a los documentos de orientación y presentar su solicitud. Por favor, envíe sus preguntas a ta-marketplace@ca-path.com.
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