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​​​​December 1, 2023 - Stakeholder News

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Local Educational Agencies (LEA) Approved to Participate in CYBHI Multi-Payer Fee Schedule

On December 1, DHCS announced the first cohort of 47 LEAs (across 25 counties) approved to participate in the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule, which will launch in January 2024, and statewide provider network. As part of the CYBHI, DHCS is expanding access to school-based (or school-linked) behavioral health services provided to students at a school site. Specifically, DHCS, in collaboration with the Department of Managed Health Care and California Department of Insurance, is establishing a statewide multi-payer school-linked fee schedule to reimburse school-linked providers for the provision of specified outpatient mental health and substance use disorder services furnished to students 25 years of age or younger at a school site. A fee schedule establishes a scope of services (e.g., psychoeducation, screening/assessment, treatment, and care coordination services), identifies billing codes and rates, and specifies provider types eligible to bill for services. Under state law, Medi-Cal managed care plans (MCP), commercial health plans, and disability insurers are obligated to reimburse eligible school-linked providers, including LEAs (e.g., services performed by pupil personnel services credentialed practitioners) and school-linked affiliated community-based organizations.

Welfare and Institutions Code section 5961.4(b) authorizes DHCS to “develop and maintain a school-linked statewide provider network of school-site behavioral health counselors." To develop the CYBHI fee schedule provider network, DHCS implemented an operational readiness review process for all interested county offices of education and LEAs. In determining LEA readiness for this cohort, DHCS considered a variety of factors, including, but not limited to, Medi-Cal enrollment, service delivery infrastructure and capacity building, data collection and documentation, and billing infrastructure. The 47 LEAs met readiness review requirements and will participate in a learning collaborative to inform state level policy and operational guidance for the CYBHI fee schedule program. Cohort 2 will launch in July 2024 and Cohort 3 in January 2025.

More information about the CYBHI fee schedule program is available on the Statewide Multi-Payer School-Linked Fee Schedule webpage.
 

Join Our Team

DHCS is hiring. DHCS has opportunities for:

  • Chief of Fee-for-Service Rates Development within Health Care Financing to develop, interpret, and issue policy on Medi-Cal reimbursement methodologies for Medi-Cal fee-for-service non-institutional and long-term care services and provider fee programs, ensuring uniform application of federal and state laws and regulations. (Final filing date (FFD) is December 20)
  • Chief of Capitated Rates Development within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS' contracted Medi-Cal managed care plans. (FFD is December 19)
  • Deputy Director of Enterprise Technology Services and Chief Information Officer to lead and manage Department-wide IT services. Responsible for managing all IT services, information security, enterprise projects, and strategic innovation efforts. (FFD is December 8)
  • Deputy Chief Counsel in the Office of Legal Services to provide advice and counsel to the directorate, deputy director and chief counsel, and other deputy directors on legal policy litigation, federal policy, financial operations, and legislation. (FFD is December 4) 

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

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, health care, legal aid, and immigrant adults. DHCS will implement this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide adults 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 and 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) Justice-Involved Program Office Hours

On December 4 at 12 p.m., DHCS will host the next PATH Justice-Involved Program virtual office hours session for Round 3 awardees (advance registration required). Office hours will be held every other Monday at 12 p.m. through December 18, 2023, to assist Round 3 agencies, including supporting implementation plan submission. For more information, visit the Justice-Involved Program website.  

Trauma Inquiry and Response in Family Planning Webinar

On December 7, from 12 to 1:30 p.m., DHCS and the California Prevention Center will host a Trauma Inquiry and Response in Family Planning webinar (advanced registration required). Trauma, including adverse childhood experiences, interpersonal violence, and sexual assault, have significant impacts on health outcomes and are common among people seeking family planning services. Trauma affects sexual and reproductive health, pregnancy, and mental health, making it important for clinicians to address trauma when providing family planning services.

This webinar will discuss the Trauma and Resilience-informed Inquiry for Adversity, Distress, and Strengths (TRIADS) framework and ways it may be useful to family planning clinicians. Using case studies, presenters will describe how the TRIADS framework establishes a foundation of empathy, respect, and compassion, thereby increasing engagement in care and improving health outcomes in patients seeking family planning services.

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.

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 California Advancing and Innovating Medi-Cal (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 Enhanced Care Management (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.

Guiding an Improved Dementia Experience (GUIDE) Model Webinar

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.

CalAIM Population Health Management (PHM) Advisory Group Meeting

On December 11, from 10:30 a.m. to 12 p.m., DHCS will host a PHM Advisory Group meeting (advance registration required). This meeting will include a briefing on policy guidance for changes to the modified Population Needs Assessment (PNA). To support the success of the PHM Program and broader transformation efforts, DHCS is redesigning MCP requirements for developing a PNA, which has historically been MCPs' primary mechanism for identifying the priority health and social needs of their members, including health disparities. A central component of DHCS' approach is for MCPs to meaningfully participate on local health departments' Community Health Assessments (LHD CHA)/Community Health Improvement Plans (CHIP) rather than complete a separate PNA focused solely on their own members' data. This meeting will provide an overview of forthcoming PHM policy guidance for MCPs to participate in LHD CHA/CHIP processes.

DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and PHM Service. Members, which include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, will participate in advisory group meetings and provide real-time feedback and recommendations. 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.

CalAIM LTC Carve-In: How Medi-Cal Managed Care Supports Subacute Care Facility and ICF/DD Home Residents Webinar

On December 15, DHCS will virtually host an educational webinar on the CalAIM long-term care (LTC) carve-in (advance registration required). The goal of this webinar is to provide subacute care facilities, intermediate care facility for developmentally disabled (ICF/DD) homes, Regional Centers, and Medi-Cal MCPs with an understanding of the policy requirements, scope of services, and benefits available to subacute care facilities and ICF/DD home residents under managed care in preparation for the January 1, 2024, carve-in. Additional details about webinars and the carve-in are available on the CalAIM LTC Carve-In Transition webpage

ECM and Community Supports Healthcare Common Procedure Coding System (HCPCS) Coding Guidance Webinar

On December 18, from 11 a.m. to 12 p.m., DHCS is hosting a webinar to provide an overview of recent updates to the ECM and Community Supports HCPCS Coding Guidance (advance registration required). DHCS initially released guidance in 2021 that includes the HCPCS codes and modifiers that must be used to report and bill for ECM and Community Supports service encounters. This includes encounter data that ECM and Community Supports services providers submit to MCPs for claiming or invoicing, and that MCPs submit to DHCS to monitor program performance and integrity. Based on feedback submitted from stakeholders throughout the early years of ECM and Community Supports implementation, DHCS has updated this guidance to increase the level of statewide data standardization and ease administrative burden.

Specifically, DHCS added new ECM and Community Supports HCPCS code/modifier combinations and codified the requirement that MCPs may not require or allow their providers to report codes or modifiers for ECM and Community Supports services beyond those defined by DHCS in the guidance. This webinar will offer MCPs, ECM and Community Supports providers, and other interested stakeholders the opportunity to learn more and ask questions about the updates made to the ECM and Community Supports HCPCS coding guidance.

Hearing Aid Coverage for Children Program (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

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.​​


Last modified date: 12/4/2023 9:03 AM