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​​​​​​​​​​​​​​​​DHCS Stakeholder Update -August 25, 2023

​​Top News

CalAIM Demonstration Amendment Approval

On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.

For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.​

​Program Updates

Medi-Cal Rx

On August 22, the Medi-Cal Rx Customer Service Center implemented an interactive voice recognition enhancement feature for members, prescribers, pharmacists, and the public. The enhancements include call surveys, main menus to streamline calls, codes to inform agents about the reasons for calls, loop back to the main menu so callers can check on multiple self-service items, and improved prompt language and placement.

On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.

Medi-Cal for Kids & Teens Informational Mailing
On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights" guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.

Join Our Team

DHCS is hiring for our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
 
DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS' goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.

​Upcoming Stakeholder Meetings and Webinars

Integrating Trauma-Informed Practices into Reproductive Health Services Webinar

On August 30, from 12 to 1:30 p.m., DHCS and the California Prevention Training Center will host an Integrating Trauma-Informed Practices into Reproductive Health Services webinar. Trauma-informed care acknowledges the need to understand a client's life experiences to deliver effective care and has the potential to improve patient engagement, treatment adherence, and health outcomes. For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website.

Tribal and Designees of Indian Health Programs Quarterly Webinar

On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.

Equity and Practice Transformation Payments Program Webinar

On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.

DHCS Coverage Ambassadors: Train the Trainer Webinar

On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors ​webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.

Nursing Facility Financing Reform Webinar

On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.

Hearing Aid Coverage for Children Program (HACCP) Webinar for Families and Community Partners

On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.

Doula Implementation Workgroup Meeting
On September 14, from 12 to 2 p.m., DHCS will host the third Doula Implementation Workgroup meeting. A link to listen to the meeting will be posted on the Doula Services as a Medi-Cal Benefit webpage by August 31. The meeting will include a report on DHCS' Birthing Care Pathway proposal and the role of doulas, and planning for future meetings. The workgroup is responsible for reviewing how to increase the availability of doula services through educational outreach programs, identifying and minimizing barriers to doula services, and addressing delays in payments and reimbursements to doulas and members.

Webinar for Medical Providers and Hearing Professionals

On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
 

In Case You Missed It

California Expands Access to Opioid Treatment in Jails and Drug Courts

On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts​ it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.

State Extends CalHOPE Schools Initiative Partnership

On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024​ the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.

Capitol Weekly Opinion on Medi-Cal Redeterminations

On August 20, Capitol Weekly ran an opinion by LA Care CEO John Baackes. LA Care is one of the Medi-Cal managed care plans in Los Angeles County. Baackes called on “all of us – neighbors, partners in government, and community advocates – to do everything we can to keep our friends and neighbors insured" by Medi-Cal.

As you interact with Medi-Cal members, please share with them helpful tips to keep their coverage. If their eligibility renewal date was in June or July, it's not too late. They can return their Medi-Cal renewal packet to the local county office today to get their coverage reinstated back to their original renewal date. Also, if Medi-Cal members moved or their contact information changed in the last few years, they should make sure their local county office has their current information so they can be reached with important renewal information. And if members receive a Medi-Cal renewal packet in the mail in a yellow envelope, they must act quickly to keep themselves and their families covered by returning renewal documents.​


Last modified date: 6/12/2024 12:43 PM