November 17, 2023 - Stakeholder News
Top News
Enhanced Care Management (ECM) and Community Supports Implementation Data
DHCS this week published the
ECM and Community Supports Implementation Update: Data Through Q2 2023. This update summarizes state-level data from ECM and Community Supports, which launched in 2022 to serve managed care plan (MCP) members with significant clinical, non-clinical, and health-related social needs. Building upon the
ECM and Community Supports Year One Report, the implementation update includes new data on Medi-Cal members and provider networks and offers a first look at ECM enrollment for the two long-term care populations of focus that became eligible for ECM in January 2023. Data for additional ECM populations of focus that launched after Q2 2023, including children and youth, will be highlighted in future reporting.
Both ECM and Community Supports continued to grow and serve more Californians during the first half of 2023, including a 29 percent growth in cumulative ECM enrollment and 108 percent growth in cumulative Community Supports recipients since the end of 2022. To provide further data transparency and visibility around ECM and Community Supports, DHCS will soon release a comprehensive report with MCP- and county-level data through Q2 2023.
2024 Medi-Cal MCP Transition Policy Guide
On November 15, DHCS released frequently asked questions (FAQs) as a companion resource to version five of the
2024 Medi-Cal MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a summary of communications resources, a transition policy for assessment and screening tools, and updates to the data sharing section and Appendix. Please email questions about the policy guide to
MCPTransitionPolicyGuide@dhcs.ca.gov. The policy guide and FAQs will be updated throughout the remainder of this calendar year to keep MCPs informed of new and developing guidance.
Program Updates
Guiding an Improved Dementia Experience (GUIDE) Model and Webinar
To help address the needs of Medicare beneficiaries, including those dually eligible for Medicare and Medi-Cal, with Alzheimer's disease and related dementias, the Centers for Medicare & Medicaid Services (CMS) released a
Request for Applications (RFA) for the GUIDE model. This model aims to support people living with dementia and their unpaid caregivers by helping them with care coordination and management, infrastructure building, and higher quality of care. Interested applicants should
submit their application via web portal by January 30, 2024.
The GUIDE model begins on July 1, 2024, and will continue for eight years. The goal of the model is to improve the quality of life, reduce the burden and strain on unpaid caregivers of people living with dementia, and prevent or delay long-term nursing home care. The care delivery approach is a person-centered plan that standardizes a set of services, has an interdisciplinary care team, and includes training requirements for the care team to improve care coordination to address the behavioral and functional needs of people living with dementia. Original Medicare providers may apply to participate. Since many Medicare beneficiaries with dementia are also dually eligible for Medi-Cal, DHCS strongly encourages California Medicare providers to participate in the GUIDE model. For more information, please visit the
CMS GUIDE webpage.
Also, on December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS' Dementia Care Aware initiative, will host a
webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware
webpage.
NOTE: DHCS will not issue a weekly stakeholder update next week. The next update will be issued on Friday, December 1.
Join Our Team
DHCS is hiring! DHCS has opportunities for:
- 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.
- Associate Medical Director for Integrated Systems of Care (FFD is November 29). This position is responsible for technical medical consultations for California's critical public health programs, and will provide advice and guidance on medically necessary services for medically fragile individuals.
- 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.
- 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
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. DHCS welcomes newly interested families, 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.
Medi-Cal Asset Elimination Webinar
On November 29, from 1:30 to 2:30 p.m., DHCS will hold a webinar for community partners, including advocates, providers, MCPs, and others, on the
elimination of assets for non-Modified Adjusted Gross Income (non-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: Subacute Care Facility Carve-In Billing and Payment Webinar
On November 29, from 3 to 4 p.m., DHCS will virtually host the
third in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) long-term care (LTC) carve-in of subacute care facilities in Medi-Cal managed care. The goal of these webinars is to provide subacute care facilities and Medi-Cal MCPs with an understanding of the carve-in to operationalize the new benefit, including scope of services and relevant policies, in preparation for the January 1, 2024, carve-in.
The webinar, which is open to the public, will focus on providing an understanding of payment policy requirements and promising practices around billing for MCPs and subacute care facilities. Additional details about the subacute care facility carve-in are available on the
CalAIM Subacute Care Facility LTC Carve-In transition 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.
CalAIM: Behavioral Health Workgroup MeetingOn December 1, DHCS will virtually convene the
CalAIM Behavioral Health Workgroup meeting to provide updates on and discussion of the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) and CalAIM behavioral health documentation redesign initiatives. Workgroup members may provide feedback on implementation and operational considerations. The meeting is open to the public. Please email questions to
BHCalAIM@dhcs.ca.gov.
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 community-based organizations, 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.
Providing Access and Transforming Health (PATH) Collaborative Planning and Implementation (CPI) Best Practices Webinar
On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar,
Relationship Building with Organizations in the CalAIM Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing ECM and Community Supports, increasing providers' successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the
PATH CPI webpage.
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.
In Case You Missed It
California Continues Medi-Cal Transformation Toward Person-Centered, Equity-Focused Care
On November 15, DHCS issued a
news release about how the Department is transforming Medi-Cal to ensure Californians can get the care they need to live healthier lives. As a result of the new Medi-Cal managed care contract, Medi-Cal members will have access to new and improved services to get person-centered, whole-person care that goes beyond the doctor's office or hospital and addresses their physical and behavioral health and health care-related social needs.
Section 1115 Demonstrations: BH-CONNECT and CalAIM Transitional Rent Amendment
On October 20, DHCS submitted to CMS the new Section 1115 demonstration request – the 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.
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.
