February 2, 2024 - Stakeholder News
Top News
Winter Storm Wellness Checks
California has experienced a series of winter storms, with severe weather continuing over the next few days. During inclement weather, our priority is to ensure people's safety and make it easier for them to access shelter, services, and other resources. We recommend that our community partners proactively check on older individuals with 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 to connect them to resources as needed. We also encourage you to work with your local county and California Governor's Office of Emergency Services (CalOES) to aid your communities, and we recommend that you become familiar with local resources you can offer to those in need, including shelters or warming centers.
To assist stakeholders with wellness checks, the California Health & Human Services Agency (CalHHS) developed an
Emergency Resource Guide, and Appendix I: Universal Wellness Checks Questionnaire can be used when conducting wellness checks. Additional resources include the
Listos California's Severe Storm Safety Toolkit and the
California Department of Public Health's Winter Storm Preparedness Toolkit.
Enhanced Care Management (ECM) and Community Supports Quarterly Implementation Report
DHCS published the
ECM and Community Supports Quarterly Implementation Report for Quarter 2 2023. This report summarizes ECM and Community Supports implementation trends and data for the first 18 months of the programs, spanning January 2022 through June 2023. Similar to the
2022 Year One Implementation Report released last August, this report provides insight into state-, county-, and Medi-Cal managed care plan (MCP)-level data.
In the first 18 months, 140,886 MCP members received the ECM benefit, and 75,834 members received 167,960 Community Supports services. As California continues advancing its Medi-Cal transformation, ECM and Community Supports play a critical role in supporting whole-person care for Medi-Cal members with complex medical and health-related social needs. DHCS expects to see more enrollment growth across both programs in the coming months and years as additional populations of focus become eligible for ECM and additional Community Supports services are offered in more counties. DHCS remains committed to supporting and sustaining this growth through program monitoring, design improvements, and standardization.
CalAIM Dashboard
DHCS today posted the first iteration of a public-facing
California Advancing and Innovating Medi-Cal (CalAIM) dashboard to demonstrate the impact, progress, and key opportunity areas of CalAIM. The dashboard includes individual initiative pages for Behavioral Health, Community Supports, ECM, Incentive Payment Program, Integrated Care for Dual Eligible Members, Population Health Management, Providing Access and Transforming Health (PATH), Statewide Managed Long-Term Care, and Bold Goals: 50x2025 as outlined in DHCS'
Comprehensive Quality Strategy. This dashboard provides baseline data and highlights milestones in the Medi-Cal transformation. The data will be updated regularly and will expand to include additional quality measures, demographic data, and initiatives as the data become available.
Program Updates
January 2024 Medi-Medi Plans Enrollment Update
Enrollment in Medicare Medi-Cal (
Medi-Medi) Plans continues to increase as part of the CalAIM initiative to offer integrated care for members who are dually eligible for Medicare and Medi-Cal. As of January 2024, enrollment in Medi-Medi Plans is approximately 293,000 members, according to data
published by the federal Centers for Medicare & Medicaid Services (CMS). This represents an increase of approximately 48,000 members over Medi-Medi Plan enrollment in October 2023. Integrated care is also available through the
SCAN Connections Health Plan and the
Program of All-Inclusive Care for the Elderly. Please visit the
Medicare Advantage Options for Dual Eligible Beneficiaries webpage to view quarterly enrollment reports for dual eligible members by Medicare delivery system.
PATH Capacity and Infrastructure Transition, Expansion, and Development (CITED) Round 3 Application
The deadline to apply for
PATH CITED Round 3 funding is February 15. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, public hospitals, county agencies, tribes, and others, to successfully participate in Medi-Cal. Weekly office hours are being held through February 12 (register on the
PATH CITED website) to assist prospective applicants.
RFI: California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Initiative Centers of Excellence (COE)
On January 31, DHCS released a
Request for Information (RFI) to solicit input from interested parties to establish one or more COEs that will offer training and technical assistance to Medi-Cal specialty behavioral health providers and county behavioral health plans. This opportunity is to support fidelity implementation of a set of evidence-based practices (EBPs), including Assertive Community Treatment (ACT), Forensic Assertive Community Treatment (FACT), Coordinated Specialty Care for First Episode Psychosis (CSC for FEP), Individual Placement and Support (IPS) model of Supported Employment, Clubhouse Services, and additional EBPs for children and youth. Please review
RFI #23-070 for more information about the specific functions of COEs and the included EBPs. The deadline for questions is February 14, and the deadline for responses to the RFI is March 1. Please submit your questions about this RFI to
PCDRFI3@dhcs.ca.gov.
Smile, California Campaign for Medi-Cal Dental Services
Smile, California is promoting National Children's Dental Health Month (NCDHM) through a campaign launched today on social media websites, including Facebook and Instagram, in both English and Spanish. The goal of the campaign is to increase Medi-Cal member knowledge of several oral care practices. The campaign educates individuals on prioritizing baby's dental visit before their first tooth grows, emphasizing the importance of dental sealants, maintaining dental-checkups two times a year, getting fluoride treatments, encouraging the avoidance of sugary food and beverages, and ensuring the correct use of toothpaste for children. Lastly, the campaign provides details on dental benefits covered by Medi-Cal.
Join Our Team
The following exam is open:
- Coordinator, Indian Health, among other roles, will serve as the principal professional consultant in Indian health to serve DHCS in the planning, development, implementation, coordination, operation, and evaluation of an Indian Health Program. (Final filing date is February 16)
Also, DHCS is hiring for our communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the
CalCareers website.
Upcoming Stakeholder Meetings and Webinars
CalAIM Population Health Management (PHM) Advisory Group Meeting
On February 12, from 10:30 a.m. to 12 p.m., DHCS will host the
PHM Advisory Group meeting. The meeting will focus on the Transitional Care Services (TCS) policy, including a summary of the TCS policy update that went into effect on January 1, 2024, for all members. PHM Advisory Group members will have the opportunity to comment on DHCS' priorities for TCS implementation in 2024, including connecting members to primary care, ensuring smooth transitions for those transitioning into or out of skilled nursing and long-term care facilities, and transitional care services for birthing individuals. Also, members will discuss how to leverage TCS to improve referring eligible individuals to ECM, Community Supports, and other services post-discharge. Additionally, DHCS welcomes recommendations from members on improving timely, thorough, and accurate transfer of data/information between discharging facilities, MCPs, and post-discharge providers.
DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and Service. Advisory group members include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups. The meetings are open to the public, and meeting information and materials will be available on the
DHCS website. Stakeholders are encouraged to submit questions in advance of the webinar to
PHMSection@dhcs.ca.gov.
Hearing Aid Coverage for Children Program (HACCP) Webinar for Medical Providers and Hearing Professionals
On February 13, from 12 to 1 p.m., DHCS will host a
HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will outline program requirements for families to apply for coverage. It will also outline the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit
www.dhcs.ca.gov/haccp.
CalAIM Subacute Care Facility Carve-In Virtual Office Hours
On February 14, from 2:30 to 3:30 p.m., DHCS will host an
office hours session as part of an educational webinar series on the CalAIM subacute care facility long-term care (LTC) carve-in. The office hours provide a dedicated forum for DHCS to engage with subacute care facilities, Medi-Cal MCP representatives, and other stakeholders to address questions related to the subacute care facility carve-in policy requirements and implementation of the transition to managed care that took effect on January 1, 2024.
Participants are encouraged to submit questions in advance when registering for the office hours session or by emailing them to
LTCtransition@dhcs.ca.gov. Additional details about past webinars are available on the
CalAIM Subacute Care Facility LTC Carve-In transition webpage.
PATH Technical Assistance (TA) Marketplace Virtual Vendor Fair
On February 29, from 9 to 10:30 a.m., DHCS will host the first
PATH TA Marketplace virtual Vendor Fair. TA Vendor Fairs are an opportunity for vendors to pitch their organization and services to potential TA recipients and encourage utilization of the
TA Marketplace. TA recipients and organizations interested in learning more about the TA Marketplace, including how to apply to receive free services, are invited to attend. This is the first in a series of upcoming Vendor Fairs and will focus on presentations from vendors providing services in Domain 3 of the PATH TA Marketplace: "Engaging in CalAIM through Medi-Cal Managed Care".
In Case You Missed It
Medi-Cal Targeted Rate Increases (TRI)
Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor's Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women's health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the
Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the
Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the
Medi-Cal TRI policy paper and
MCO Tax-funded investments.
CalAIM Continuous Coverage for Children Public Comment
The 30-day public comment period for the
CalAIM Section 1115 Continuous Coverage for Children amendment application is from January 12 through February 12. To ensure consideration prior to submission to CMS, comments must be received no later than 11:59 PM PST on February 12. DHCS welcomes all public comments.
DHCS is requesting to amend the CalAIM Section 1115 demonstration to include expenditure authority under Section 1115(a)(2) to receive federal matching funds to provide continuous coverage for children through the end of the month in which their 5th birthday falls, regardless of when they first enroll in Medi-Cal or the Children's Health Insurance Program and any changes in circumstances that would otherwise cause a loss of eligibility. Implementation of this policy is contingent upon a state determination of available General Fund resources in 2024-2025 and subsequent fiscal years and CMS approval. Additional information is available on the
DHCS CalAIM 1115 Demonstration and 1915(b) Waiver webpage.
Medicare Coverage of Behavioral Health Services
On January 30, DHCS and the California Department of Aging published a
fact sheet for providers about Medicare behavioral health benefits, including highlights of expanded services and provider types available through Medicare in 2024. Starting January 1, 2024, Medicare coverage and policies for behavioral health have expanded to cover mental health services and visits with marriage and family therapists and mental health counselors, cover intensive outpatient services in certain settings, and strengthen requirements for Medicare Advantage plans to coordinate behavioral health care.
The fact sheet covers behavioral health services covered by Medicare, how to enroll as a Medicare provider and participate in Medicare, how providers can help Medicare beneficiaries access care, and 2024 changes in Medicare for behavioral health. Behavioral health services include both mental health and substance use disorder treatment. Both are underutilized in California among Medicare beneficiaries. In 2021, only 8.8 percent of Californians age 65 and older saw a health care professional for mental health or substance use disorders. Barriers to receiving Medicare-covered treatment include a lack of awareness that Medicare covers behavioral health services, a need to increase the number of behavioral health providers enrolled in Medicare, and the stigma that may be associated with seeking treatment.
