October 14, 2024 - Stakeholder Update
Top News
DHCS Justice-Involved Reentry Initiative Goes Live
On October 1, DHCS
launched the Justice-Involved Reentry Initiative, which is designed to provide a targeted suite of medical and mental health services for youth and adults in state prisons, county jails, and youth correctional facilities in the 90 days prior to their release, aiming to ensure a smoother transition and improving overall well-being and public health outcomes. Three counties – Inyo, Santa Clara, and Yuba – were approved as of October 1 to begin delivering Medi-Cal services to people returning to communities after incarceration. Additional counties will begin offering services in early 2025.
California is the first state in the nation to receive federal approval and implement this historic initiative. For those eligible, a care manager will be assigned—either in-person or via telehealth—to establish a relationship with the individual, understand their health needs, coordinate vital services, and make a plan for community transition. The Justice-Involved Reentry Initiative is designed to help stabilize chronic and significant clinical health conditions, including mental illness and substance use disorders, and to facilitate a coordinated reentry to support smoother transitions and improve public health. Further, the Justice-Involved Reentry Initiative aims to close equity gaps and improve health outcomes for people who are or have been incarcerated.
DHCS worked closely with its implementation partners, including the California Department of Corrections and Rehabilitation, county jails and probation, county behavioral health and social services, Medi-Cal managed care plans, community-based providers, and Tribal partners, to launch the Justice-Involved Reentry Initiative. Correctional facilities have the flexibility to determine their go-live dates between October 1, 2024, and September 30, 2026, and will be subject to a DHCS readiness review process before they can launch.
Program Updates
Medi-Cal's Superior Systems Waiver
The federal Centers for Medicare & Medicaid Services approved the Superior Systems Waiver (SSW) renewal application, effective from October 1, 2024, through September 30, 2029. The SSW describes the utilization review process for acute inpatient hospitals that serve fee-for-service Medi-Cal patients. Under SSW authority, DHCS employs the following utilization review approaches, depending on the type of acute inpatient service, hospital type, and characteristics of the member's health care coverage:
- Treatment Authorization Request (TAR) process: The TAR process requires DHCS to authorize inpatient hospital services prior to approving reimbursement. Hospitals submit TARs to DHCS for review and approval of admissions to ensure medical necessity prior to claiming for services.
- TAR-Free process: The TAR-Free process requires hospitals to use evidence-based, standardized medical review criteria to determine medical necessity and claim for inpatient hospital services, while DHCS performs post-payment clinical and administrative compliance reviews using statistically valid samples of paid inpatient hospital claims.
Please see the
SSW webpage for more information, and please email your questions to
SSWRenewal@dhcs.ca.gov. The
Cal Health Find database includes listings of different facilities, including acute care hospitals.
Join Our Team
DHCS is seeking highly skilled, exceptionally motivated individuals to serve as:
- Chief, Provider Enrollment Division (PED) to lead the development and implementation of policies, processes, and services related to provider enrollment, including screening, enrolling, and recertifying Medi-Cal providers. Additionally, the Chief of PED has full responsibility for the development and implementation of regulatory and process changes to business requirements and enhancements for the Provider Application and Validation for Enrollment system. (Final filing date: October 14)
- Chief, Local Governmental Financing Division to provide organizational leadership and develop policy in support of Medi-Cal Behavioral Health and Local Educational Agency service programs as well as other local and county governmental federal reimbursement and financing oversight activities. (Final filing date: October 18)
DHCS is also hiring for its auditing, health policy, information technology, and other teams. For more information, please visit the
CalCareers website.
Upcoming Stakeholder Meetings and Webinars
Behavioral Health Task Force (BHTF) Webinar
On October 15, from 12 to 1:30 p.m. PDT, the
BHTF will hold a
webinar on population-based prevention (advanced registration is required). Participants include Dr. Tomás Aragón, MD, DrPH, Director of the California Department of Public Health (CDPH) and State Public Health Officer, and Julie Nagasako, Deputy Director of the Office of Policy and Planning at CDPH. This webinar will help prepare attendees for an in-depth discussion at the November 13 BHTF quarterly meeting. The webinar will be recorded and posted on the
BHTF website. For questions, comments, or to join the BHTF listserv, please email
BehavioralHealthTaskForce@chhs.ca.gov.
Stakeholder Advisory Committee (SAC)/Behavioral Health (BH)-SAC Meeting
On October 16, from 9:30 a.m. to 3 p.m. PDT, DHCS will host the hybrid
SAC/BH-SAC meeting (advance registration required for online and in-person participation) at 1700 K Street (first-floor conference room 17.1014), Sacramento. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts and helps DHCS further its efforts to provide high-quality, equitable care. BH-SAC provides DHCS with input regarding behavioral health activities and was created as part of the ongoing effort to integrate behavioral health with the greater health care system. It incorporates existing groups that have advised DHCS on behavioral health topics. The agenda is available in the
meeting materials. For more information, please email
SACinquiries@dhcs.ca.gov or
BehavioralHealthSAC@dhcs.ca.gov.
DHCS Harm Reduction Summits
Registration is currently open for the first two DHCS Harm Reduction Summits in Shasta County (October 24) and San Mateo County (November 19). Through these convenings, DHCS aims to collaborate with communities across the state to promote harm reduction within California's substance use disorder (SUD) treatment system and create low-barrier, patient-centered care. DHCS encourages SUD treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in SUD treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into SUD treatment. Additional summits will be held in Fresno County, Los Angeles County, and San Diego County in winter 2025. Register on the
event website.
Chosen Family Webinar: Contraception for Transgender and Gender Diverse People
On October 29, from 10 a.m. to 11:30 a.m. PDT, DHCS and the California Prevention Training Center will host the
Chosen Family: Contraception for Transgender and Gender Diverse People webinar (advanced registration required). Transgender and gender diverse (TGD) people represent a growing subset of patient populations, yet many continue to report a lack of provider knowledge when it comes to TGD health. This webinar will build upon TGD health terminology and competency essentials by reviewing evidence-based recommendations for contraceptive counseling. 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 at a later date.
Skilled Nursing Facility Workforce Standards Program
On November 6, from 10 to 11 a.m. PST, DHCS will host a provider
webinar (advance registration required) to provide an overview of the Skilled Nursing Facility (SNF) Workforce Standards Program (WSP) opt-in process launched by DHCS on October 1. Providers can send questions they would like answered during the webinar to
SNFWSP@dhcs.ca.gov by October 30.
This program will provide an increased Workforce Rate Adjustment to SNFs that maintain a collective bargaining agreement, participate in a statewide multi-employer labor management committee, or meet basic wages and benefit standards established by DHCS. The SNF WSP makes available more than $500 million annually to enable SNFs to recruit and retain a workforce that provides high-quality long-term care to Medi-Cal members. SNFs wishing to participate in the WSP for calendar years 2024 and 2025 must submit the required opt-in materials no later than December 1, 2024. Please visit the
SNF WSP webpage for more information.
Hearing Aid Coverage for Children Program (HACCP) Webinar for Medical Providers and Hearing Professionals
On November 12, from 12 to 1 p.m. PST, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to
register, please visit DHCS'
HACCP webpage.
HACCP Webinar for Families and Community Partners
On December 3, from 11 a.m. to 12 p.m. PST, DHCS will host a webinar to share guidance with families and community partners about applying for hearing aid coverage and maximizing HACCP benefits once enrolled. For more information and to
pre-register, please visit the
HACCP webpage.
In Case You Missed It
Critical Funding Opportunity Available to Expand Behavioral Health Services
On July 17, DHCS
released the Bond Behavioral Health Continuum Infrastructure Program (BHCIP) Round 1: Launch Ready
Request for Applications. Eligible organizations can apply for funding to construct, acquire, and rehabilitate properties for behavioral health services for Medi-Cal members. Interested parties can find application instructions on the
BHCIP website and must sign up for a pre-application consultation by October 15 in order to be eligible. Applications must be submitted by December 13. This initiative, part of Proposition 1, seeks to transform California's mental health and substance use disorder systems, providing more comprehensive care for the state's most vulnerable populations. For more information, contact DHCS at
BHTinfo@dhcs.ca.gov
Supporting Mental Health
DHCS, in concert with The Children's Partnership, announced the awarding of $8 million to eight California high schools to serve as pilot sites to conduct the Peer-to-Peer Youth Mental Health Program. The awards are part of Governor Gavin Newsom's Children and Youth Behavioral Health Initiative, a cornerstone of his Master Plan for Kids' Mental Health. The program was designed in collaboration with youth to identify promising, evidence-based peer-to-peer interventions to improve youth mental health.
