DHCS Stakeholder News – January 13, 2023
اخبار برتر
بهروزرسانیهای اورژانس بهداشت عمومی Medi-Cal COVID-19 (PHE) و برنامه عملیاتی بازگشایی پوشش مستمر
On January 13, DHCS updated the Medi-Cal COVID-19 PHE and Continuous Coverage Unwinding Operational Plan to incorporate policy changes as a result of the federal Consolidated Appropriations Act of 2023 enacted on December 29, 2022, and corresponding guidance released from the Centers for Medicare & Medicaid Services (CMS) in the form of a CMCS Informational Bulletin on January 5, 2023. The updated plan reflects the delinking of the continuous coverage requirement from the PHE as of April 1, 2023, setting the stage for the resumption of Medi-Cal redeterminations.
The plan is intended to inform the public about DHCS’ approach to return Medi-Cal to a normal state of operations. The plan also includes additional resources, including information about the DHCS Coverage Ambassadors campaign and links to CMS guidance documents.
چک های سلامتی طوفان زمستانی
California has experienced a series of devastating storms, with predicted severe weather continuing, potentially resulting in damaging winds, heavy rain, and flooding. We must double down on our communication efforts over the coming days as additional rain is expected statewide through the next several days.
Over the next three days, we ask that you focus your efforts on Wellness Checks for your populations. Please encourage others to use these resources to check on neighbors, family, and friends.
چک سلامتی 101s
During inclement weather, the priority should be on ensuring people’s safety in emergencies and making it easier for them to access shelter and other resources by removing all possible barriers.
We recommend that our community partners proactively check on individuals who are older, have disabilities, are unhoused, and/or have chronic health conditions that may put them at-risk. Reach out to them to check on how they’re doing and connect them to resources as necessary.
We encourage you to work with your local county and Office of Emergency Services to aid your communities. We also recommend that you and your staff become familiar with local resources that you can offer to those in need, including local shelters or warming centers.
To assist stakeholders with wellness checks, the California Health & Human Services Agency (CalHHS) developed an Emergency Resource Guide, Appendix I: Universal Wellness Checks Questionnaire that can be used when conducting wellness checks.
راهنمای آمادگی اضطراری / جعبه ابزار برای افراد دارای معلولیت
The California Office of Emergency Services (CalOES) and Department of Rehabilitation have developed an Emergency Preparedness Guide/Toolkit for Individuals with Disabilities available in multiple languages that includes information and emergency preparedness tips for individuals with specific types of disabilities.
Evacuation: Please make sure that if local officials issue evacuation orders, please evacuate.
Stay Updated: Follow CalOES and your local emergency officials for real-time updates about the storm and its threats. Sign up for local alerts at calalerts.org.
We appreciate your efforts as we work together to improve preparedness and response to disasters and emergencies.
Governor’s Fiscal Year (FY) 2023-24 Proposed Budget
Governor Gavin Newsom proposed a $144.4 billion budget for DHCS programs and services in the next FY. The budget for DHCS supports 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 the expansion of full scope Medi-Cal coverage to all adults regardless of immigration status beginning January 1, 2024, CalAIM justice-involved initiatives, and provider rate changes. DHCS is also proposing the Behavioral Health Community-Based Continuum (CalBH-CBC) demonstration to expand access and strengthen mental health services for Medi-Cal members living with serious mental health illness and serious emotional disturbance. Additionally, DHCS will develop an 1115 demonstration waiver to support the state’s reproductive health safety net.
- DHCS FY 2023-24 Governor’s Budget Highlights (January 10)
- Governor’s Proposed Budget (January 10)
- برآوردهای کمک محلی Medi-Cal
- برآورد کمک محلی بهداشت خانواده
- SMHS Budget Supplement – M22 (January 10)
- نمودارهای مکمل Drug Medi-Cal (10 ژانویه)
وزارت بهداشت و خدمات انسانی ایالات متحده (HHS) PHE را تمدید کرد
On January 11, HHS renewed the federal COVID-19 PHE for a full 90-day extension through April 11. The formal PHE declaration was posted on the HHS website. The Biden Administration has committed to providing a minimum 60-day advance notice before it ends the PHE. Please contact the DHCS Medi-Cal Eligibility Division COVID inbox at MCED.COVID@dhcs.ca.gov with any questions.
به روز رسانی برنامه
بهروزرسانیهای Medi-Cal Telehealth
DHCS has released several updates to the Medi-Cal Telehealth webpage that reflect DHCS’ current telehealth policy:
- صفحهسوالات متداول (FAQ).
- Telehealth Policy Paper
- طرحتحقیق و ارزیابی سلامت از راه دور
- دفترچه راهنمای ارائه دهندگان خدمات درمانی از راه دور (قرار است در ۱۳ ژانویه بهروزرسانی شود)
As reflected in the Telehealth Policy Paper, most telehealth coverage policies will be maintained after the expiration of the federally declared COVID-19 PHE.
Please email Medi-Cal Telehealth@dhcs.ca.gov with any questions or comments.
به روز رسانی Medi-Cal Rx
Beginning on January 20, the next wave of reinstatement of prior authorization (PA) will include PAs for an additional 39 therapeutic classes, followed by the remaining therapeutic classes (excluding enteral nutrition products) on February 24. At that time, PA requirements will be fully reinstated for members age 22 and older. For claims that are paying under the Transition Policy due to claim history, a provider may submit a PA before the end of the transition period, beginning on February 24. For additional details, visit the reinstatement page of the Medi-Cal Rx website. Additionally, Medi-Cal Rx began publishing a weekly newsletter (“Reinstatement Spotlight”) to support stakeholder engagement and education, and to provide stakeholders with links to recently published resources and informational updates.
افزایش درخواست جوانان کالیفرنیا (EYC) برای برنامه ها (RFA)
در 16 ژانویه، DHCS یکی دیگر از EYC RFA را برای سازمانهای محلی و قبیلهای منتشر میکند تا ظرفیت سازمانی برای اجرای عدالت اجتماعی جوانان، مشاوره و برنامههای پیشگیری از حمایت همتایان در جوامعی که به طور نامتناسبی تحت تأثیر جنگ با مواد مخدر قرار گرفتهاند، ایجاد کنند. با بودجه پیشنهادی 64 آموزش، پیشگیری، مداخله زودهنگام و حساب درمان جوانان، نزدیک به 17 میلیون دلار در دسترس است و سازمان ها می توانند برای هرکدام تا سقف 400000 دلار درخواست کمک مالی کنند. برای اطلاعات بیشتر، به وب سایت EYC مراجعه کنید.
مسکن پل سلامت رفتاری (BHBH)
DHCS در حال حاضر با سهامداران کار می کند تا استراتژی بودجه و استفاده های مجاز برای برنامه BHBH را برای رسیدگی به نیازهای فوری مسکن و درمان افرادی که بی خانمانی بدون سرپناه را تجربه می کنند و دارای شرایط بهداشتی رفتاری جدی هستند، نهایی کند. یک RFA در اواخر ژانویه 2023 به آژانس های بهداشت رفتاری شهرستان برای مشارکت در این دور اول بودجه برنامه کمک هزینه ارسال می شود. برای دور دوم بودجه، یک RFA در بهار 2023 برای نهادهای قبیله ای منتشر می شود تا برای کمک مالی درخواست دهند. برای اطلاعات بیشتر، لطفاً به وب سایت BHBH مراجعه کنید.
آخرین مهلت درخواست برای پرداخت های حفظ تثبیت نیروی کار کلینیک (CWSRP)
DHCS reminds all successfully registered qualified clinics to submit their CWSRP applications before the deadline. All requests for payment must be submitted no later than 5 p.m. on January 27. DHCS encourages early submissions so all applications can be validated shortly after the application submission deadline.
For application guidance, an application video tutorial, and all other supporting information, please visit the CWSRP webpage.
مقاله مفهومی طرح یکپارچه سازی اداری سلامت رفتاری CalAIM
In January, DHCS will publish a concept paper on the California Advancing and Innovating Medi-Cal (CalAIM) Behavioral Health Administrative Integration initiative, which aims to consolidate Medi-Cal programs for Specialty Mental Health Services and Drug Medi-Cal or Drug Medi-Cal Organized Delivery System services into a single county-based behavioral health program by FY 2027-28. The concept paper will include an overview of the initiative’s framework and goals, the phased approach for implementation between now and FY 2027-28, and DHCS’ proposal for ongoing stakeholder engagement and technical assistance.
DHCS will accept stakeholder feedback on the concept paper through February 13. The concept paper will be available on the CalAIM Behavioral Health webpage.
کمپین لبخند، کالیفرنیا برای خدمات دندانپزشکی Medi-Cal
In the coming weeks, Smile, California will debut a new tri-fold brochure for new and expecting parents, entitled “Healthy Smiles from Pregnancy Through the Toddler Years”. The brochure will be available in English, Spanish, Vietnamese, Chinese, and Korean, and will be available to view and download on SmileCalifornia.org.
به تیم ما بپیوندید
DHCS is hiring! We are currently searching for a mission-driven, motivated individual to serve as the Chief of the Medi-Cal Eligibility Division. This position provides leadership, direction, and coordination of Medi-Cal and Children’s Health Insurance Program eligibility policy and operations. We are also hiring a Chief of the Human Resources Division.
DHCS is also hiring Californians to join our fiscal, human resources, legal, auditing, health policy, 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, and 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.
جلسات و وبینارهای ذینفعان آینده
وبینار CalAIM مدیریت سلامت جمعیت (PHM) در مورد خدمات مراقبت انتقالی
On January 19, from 2:30 to 4 p.m., DHCS will host a webinar to discuss Transitional Care Services (advance registration required) under the PHM Program, a cornerstone of CalAIM. Transitional Care Services support individuals undergoing a transition from one setting or level of care to another (e.g., discharge from hospital to home) to promote continuity of care and limit service disruptions. The webinar will feature a panel discussion on emerging practices for implementing Transitional Care Services for high-risk members in 2023, and an overview of the latest requirements, including the phased implementation timeline.
وبینار CalAIM بزرگسالان و جوانان و انتقال ابزارهای مراقبتی برای خدمات بهداشت روانی Medi-Cal
در 19 ژانویه، از ساعت 3 تا 4 بعد از ظهر، DHCS میزبان یک وبینار (ثبت نام قبلی است) برای ذینفعان برای آشنایی با طرح غربالگری بزرگسالان و جوانان و انتقال ابزارهای مراقبتی برای خدمات بهداشت روانی Medi-Cal، که در 1 ژانویه به صورت زنده آغاز شد. به عنوان بخشی از CalAIM، این ابتکار بر اجرای ابزارهای غربالگری و انتقال مراقبت در سراسر ایالت برای بزرگسالان و افراد زیر 21 سال برای استفاده توسط برنامه های مراقبت مدیریت شده Medi-Cal (MCPs) و برنامه های سلامت روان شهرستان متمرکز شده است. این وبینار شامل یک مرور کلی از هدف ابتکار، مروری بر راهنمای نهایی و ابزارها و پاسخ به سوالات متداول خواهد بود.
وبینار تجزیه و تحلیل شکاف خدمات خانگی و مبتنی بر جامعه (HCBS).
On January 20, from 1 to 3 p.m., DHCS, in partnership with the California Department of Aging (CDA), will host a stakeholder engagement webinar (join at scheduled time) to present the preliminary approach for the Statewide HCBS Gap Analysis. This analysis will inform the development of a multiyear roadmap to address identified gaps in the service delivery system. DHCS’ gap analysis will focus on the Medi-Cal population and services and CDA’s will target aging and disability populations and services outside of Medi-Cal. This will be the first of multiple stakeholder engagement efforts. To be included on the invitation list for upcoming webinars, please email HCBSGapAnalysis@dhcs.ca.gov.
وبینار برنامه پوشش کمک شنوایی برای کودکان (HACCP) برای ارائه دهندگان
در 24 ژانویه، از ساعت 12 تا 12:50، DHCS میزبان یک وبینار HACCP (الزام به ثبت نام قبلی) برای به اشتراک گذاشتن اطلاعات با ارائه دهندگان خواهد بود تا آنها بتوانند بهتر به بیماران اطفال و خانواده هایشان کمک کنند تا مزایای HACCP را به حداکثر برسانند. این جلسه آموزشی به الزامات برنامه برای خانواده ها برای درخواست پوشش و روند ارسال ادعاها برای شنوایی شناسان، گوش و حلق و بینی، پزشکان و کارکنان مطب آنها می پردازد.
وبینار اجمالی مقاله مفهومی ادغام مدیریت سلامت رفتاری CalAIM
On January 26, from 3 to 4 p.m., DHCS will host a webinar to provide an overview of the concept paper for CalAIM Behavioral Health Administrative Integration (advance registration required). The webinar will include an overview of the initiative’s framework and goals, the phased approach for implementation between now and FY 2027-28, and DHCS’ proposal for ongoing stakeholder engagement and technical assistance. For more information, visit the CalAIM Behavioral Health Initiative webpage.
نشست نهایی گروه کاری ذینفعان برای توسعه سیاست دولا
در 26 ژانویه، از ساعت 1 تا 3 بعد از ظهر، DHCS به طور مجازی میزبان آخرین جلسه گروه کاری سهامداران عمومی (در زمان برنامه ریزی شده به وبینار بپیوندید) در مورد افزودن خدمات doula به عنوان یک مزیت تحت پوشش Medi-Cal خواهد بود. در جلسه نهایی، DHCS ارائه ای در مورد نحوه قرارداد doulas با MCP ها ارائه می دهد و در مورد برنامه های کارگروه بعدی doula که در ماه مارس آغاز می شود، بحث خواهد کرد. طبق لایحه 65 سنا (فصل 449، اساسنامه سال 2021)، کارگروه اجرای دولا اجرای این مزایا را بررسی خواهد کرد.
در صورتی که شما آن را از دست داده است
کالیفرنیا سرمایه گذاری 52 میلیون دلاری در خدمات پیشگیری و درمان مواد افیونی را اعلام کرد
On January 11, Governor Newsom issued a news release announcing that DHCS awarded $52 million to providers of Medication-Assisted Treatment (MAT) services to support the prevention, assessment, diagnosis, and treatment of opioid and substance use disorders, as well as recovery. To learn more about the California MAT Expansion project, visit the California MAT website.
برنامه Youth Opioid Response California 3 (YOR 3).
DHCS released a RFA to strengthen capacity and access to prevention, treatment, and recovery services, as well as access points to MAT, for youth (ages 12-24) and their families. This opportunity is designed to foster the coordination and strengthening of existing multi-system networks and encourage the development of new partnerships between agencies reaching youth. Implementation grantees may receive up to $750,000, and capacity-building grantees may receive up to $50,000. For more information and to apply by the January 19 deadline, please visit the YOR CA website or email YORCalifornia@ahpnet.com.
بحران قبیله ای و مراقبت های بهداشتی رفتاری غیر بحرانی RFA
On January 11, DHCS released a RFA to solicit applications from California Tribal entities to expand access to Tribal crisis and non-crisis behavioral health care through the infrastructure funding. This funding must be used exclusively for vehicles and allowable vehicle-related costs to improve access to behavioral health mobile crisis and non-crisis services. The project period will be from February 1, 2023, through June 30, 2025. Eligible California Tribal entities providing behavioral health services can apply for funding ranging from $50,000 to $1,000,000. The deadline to apply is February 13.
اطلاعات صورتحساب ارائه دهنده مدیکر برای بیماران واجد شرایط دوگانه
DHCS published an updated fact sheet and toolkit for Medicare providers to explain the provider billing process for dual eligible members enrolled in Medi-Cal managed care. This fact sheet describes the existing crossover billing process, which does not change under CalAIM. Medicare providers serving dual eligible patients do not need to enroll in a Medi-Cal MCP to continue receiving reimbursement. More than 70 percent of dual eligible members statewide are already enrolled in Medi-Cal MCPs. Medicare benefits and providers do not change upon enrollment in a Medi-Cal MCP.
For patients in Original (fee-for-service) Medicare, the Medicare Administrative Contractor processes the primary claim for Medicare payment, and then forwards the claim to the Medi-Cal MCP (or DHCS) for secondary Medi-Cal payment. For patients in Medicare Advantage (MA), the Medicare provider bills the MA plan for primary payment. The secondary payment process may depend upon whether the patient’s Medi-Cal MCP is the same as or different than the MA plan. For more information, please visit the Statewide Medi-Cal Managed Care Enrollment for Dual Eligible Members webpage.
گسترش واجد شرایط بودن برنامه پوشش سمعک برای کودکان (HACCP).
Effective January 1, DHCS welcomes newly eligible young adults ages 18 to 20 who meet other program criteria and need coverage for their hearing aid(s) and related services to apply for HACCP enrollment. Also, effective January 1, applicants under age 21 who meet program eligibility requirements may apply to enroll in HACCP even if they have partial other health coverage for hearing aids subject to a coverage limit of $1,500 or less per year. Additional program information is available on the HACCP webpage. Families can apply to enroll for coverage through HACCP’s Online Application Portal.