November 10, 2023 - Stakeholder News
Top News
Enhanced Care Management (ECM) for Children and Youth Populations of Focus (POF) Spotlight
On November 3, DHCS published the
ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California's growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the
ECM and Community Supports webpage.
Program Updates
Medi-Cal and Foster Care Updates
DHCS developed a resource to provide updates on
foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
Doula Services Updates Available Online
On November 3, DHCS updated the
Doula Services as a Medi-Cal Benefit webpage. The updated webpage includes helpful resources for Medi-Cal members and doula providers, including the newly issued standing recommendation for doula services from DHCS Medical Director Dr. Karen Mark. The standing recommendation fulfills the federal requirement for a recommendation for doula services as a preventive service.
Updates to the webpage also include new frequently asked questions for doulas and Medi-Cal members, the total number of approved doula provider applications and enrolled individual providers, and information on evidence that supports the benefits of doula services for birth and maternal outcomes. Please email any questions about doula services to
DoulaBenefit@dhcs.ca.gov.
Join Our Team
DHCS is hiring! DHCS has opportunities for:
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
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Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
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Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
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Senior Assistant Chief Counsel for Health Care Delivery Systems within the Office of Legal Services (FFD is November 30). This position is responsible for complex legal counsel and litigation strategy formulation regarding various aspects of the health care delivery system.
DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the
CalCareers website.
Upcoming Stakeholder Meetings and Webinars
Keep Your Community Covered: Schools and Families Webinar
On November 16, from 2 to 3 p.m., DHCS will hold a
webinar on Keep Your Community Covered: Schools and Families (advance registration required). The webinar will provide school partners with important information to assist students and their families with renewing Medi-Cal coverage. The webinar will also highlight available outreach resources and best practices for engaging families with school age children.
Medi-Cal Enrollment Requirements and Procedures for CBOs and LHJs Webinar
On November 17, from 10 to 11:30 a.m., DHCS will hold a
public stakeholder hearing via webinar (advance registration required) to discuss the regulatory provider bulletin on Medi-Cal enrollment requirements and procedures for community-based organizations (CBO) and local health jurisdiction (LHJ) providers that offer community health worker and/or asthma preventive services. Effective January 9, 2024, CBO and LHJ providers requesting enrollment in the Medi-Cal fee-for-service program can submit their application through the Provider Application and Validation for Enrollment (PAVE) online enrollment portal.
Written comments, questions, or suggestions may be submitted during the hearing in the webinar chat. For those unable to attend, written comments must be submitted by 5 p.m. on November 17 to be considered for publication. When submitting comments in writing, please ensure that the commenter and organization/association being represented are both identified in the comments. Written comments should be submitted to
DHCSPEDStakeholder@dhcs.ca.gov. Based on the public comments received, DHCS will publish the final bulletin on the
Medi-Cal and
DHCS websites.
CalAIM Intermediate Care Facility for the Developmentally Disabled (ICF/DD) Carve-In Billing and Payment WebinarOn November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the
California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this
registration form or by emailing them to
LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the
CalAIM ICF/DD Long-Term Care Carve-In webpage.
Nursing Facility Financing Reform WebinarOn November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the
Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by
Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS'
Nursing Facility Financing Reform (AB 186) webpage.
Hearing Aid Coverage for Children Program (HACCP) Webinar for Families and Community Partners
On November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit
www.dhcs.ca.gov/haccp.
HACCP Webinar for Medical Providers and Hearing Professionals
On December 19, 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 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.
Medi-Cal Asset Elimination Webinar
On November 29, from 1:30 to 2:30 p.m., DHCS will hold a webinar on the
elimination of assets for non-Modified Adjusted Gross Income (MAGI) Medi-Cal programs, effective January 1, 2024. When implemented, this initiative will eliminate the asset test for all non-MAGI programs, including long-term care and Medicare Savings Programs. The webinar will provide background information on the asset elimination, implementation planning, procedural changes, and outreach materials. More information is available on the
Asset Limit Changes for Non-MAGI Medi-Cal webpage.
CalAIM Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup Virtual Meeting
On November 30 at 10 a.m., DHCS will virtually host the
CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the
CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at
info@calduals.org.
Medi-Cal Adult Expansion Webinar
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the
adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to
AdultExpansion@dhcs.ca.gov.
In Case You Missed It
Section 1115 Demonstrations: BH-CONNECT and CalAIM Transitional Rent Amendment
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the
California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the
proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for
BH-CONNECT and
CalAIM transitional rent services from October 27 through November 26, 2023.
January 2024 Medi-Cal MCP Transition
As part of
Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the
Managed Care Plan Transition Member webpage with a county “lookup" tool, links to member
notices sent by Medi-Cal about MCP changes,
frequently asked questions, and a
Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for
providers and
MCPs and stakeholders. More information about the transition is available in the
2024 Managed Care Plan Transition Policy Guide and
Medi-Cal Eligibility Division Information Letter Number I 23-54.