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DHCS Seeks Input on Independent Evaluations of CalAIM and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Initiatives
On June 14, DHCS released the California Advancing and Innovating Medi-Cal (CalAIM) 1115 Demonstration Independent Evaluation Request for Information (RFI). This RFI aims to gather input and provide information on the evaluation of several components of the CalAIM 1115 initiatives, including Providing Access and Transforming Health (PATH), Global Payment Program (GPP), Medi-Cal matching plan policy for dually eligible beneficiaries, and the Reentry Demonstration Initiative, in addition to the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) 1115 waiver.
To comply with CMS requirements, states must arrange for an independent party to conduct evaluations of all 1115 demonstrations to assess their impacts on members, providers, health plans, and the state. The evaluation will include the demonstration's impacts on access, quality of care, and costs. The deadline for RFI submissions is July 12 at 4 p.m. Information about the RFI is available on the DHCS Contracts Division webpage.
Program Updates
California Continuous Coverage Unwinding Report
DHCS posted California's Medi-Cal eligibility unwinding dashboard for March 2023 on the Medi-Cal enrollment landing page. California will begin processing disenrollments in June, with an effective date of July 1. The corresponding report displaying the first set of disenrollments will be available in August. The report shows California's total Medi-Cal enrollment count over a 13-month period. The report also includes information on new applications and monthly redetermination processing—including renewals due; how many members were renewed via ex-parte; and information on disenrollments. All measures are also available broken down by county in the county stratification table. DHCS plans to post this information no later than the second week of each month.
Continuous Coverage Unwinding County Readiness Plan Summary
On June 16, DHCS posted the Continuous Coverage Unwinding County Readiness Plan Summary report. The summary provides overviews of county continuous coverage unwinding readiness plans, including challenges in renewal processing during the unwinding, best practices to modify business processes, and DHCS technical assistance provided to counties. On January 10, DHCS published Medi-Cal Eligibility Division Letter 23-03, requiring all 58 counties to submit a readiness plan to prepare for the end of the continuous coverage requirement resulting from the Families First Coronavirus Response Act. The readiness plan covers key areas for counties to review and assess in order to prepare for the resumption of annual Medi-Cal redeterminations and eventual return to normal business operations, including organization and staffing, staff training for Medi-Cal related case activities, and lobby management, call center, and outreach efforts.
Care Economy Payments for Home and Community-Based Services (HCBS) Direct Care Workers
The application for the Care Economy Payment for HCBS Direct Care Workers is now live, and submissions will be accepted through July 10, 2023. DHCS encourages early application submission to allow ample time for validation and processing before the due date. DHCS anticipates issuing payments to approved provider organizations in November, and applicants receiving funding must issue payments to qualified employees within 60 days of receipt. For more information, please visit the Care Economy Payments for HCBS Direct Care Workers webpage.
Funding Opportunity: Traditional Indian Health (TIH) Request for Application (RFA) Release
DHCS released the Round Two RFA to fund two TIH education programs that will assist Indian clinics in providing services to American Indians in a culturally appropriate manner and create a forum for the Indian community to address TIH education. A total of $200,000 is available to fund regional TIH programs for two fiscal years. This funding opportunity supports the provision of traditional Indian health care.
Anticipated funding includes $100,000 per region, supporting Southern California and statewide urban regional programs. The maximum funding is $50,000 per region per fiscal year. The grant term is projected to start in August 2023 and continue until June 30, 2025. For questions about the RFA, please email TribalAffairs@dhcs.ca.gov.
Medi-Cal Rx
On June 23, Medi-Cal Rx Reinstatement Phase III, Lift 4 will be implemented, lifting the Transition Policy for 46 Standard Therapeutic Classes. This is the fourth in a series of lifts to retire the Transition Policy by reinstating NCPDP Reject Code 75 – Prior Authorization Required.
Join Our Team
DHCS is hiring. DHCS has an immediate opening for Deputy Director, Office of Communications, which closes on July 3, 2023. This executive role leads DHCS' communications team to support the Department's overall goals and objectives to drive awareness and education of DHCS' programs and activities across media relations, digital communications (website and social media strategies), stakeholder engagement, and message development.
DHCS is also 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 preserving and improving the overall health and well-being of all Californians. The Department's mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
Upcoming Stakeholder Meetings and Webinars
Hearing Aid Coverage for Children Program (HACCP) Webinars
On June 21, from 11 to 11:40 a.m., DHCS will host a family and community partners webinar session (advance registration required) to provide information to help children and their families apply for HACCP coverage and access covered benefits once enrolled. The training session will address program eligibility and best practices for working effectively with your child's medical care team to access benefits quickly and easily.
On June 22, from 12 to 12:45 p.m., DHCS will host a provider webinar session (advance registration required) to provide information to help pediatric patients and their families maximize HACCP benefits. The training session will address the program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, other physicians, and their office staff.
MLTSS and Duals Integration Workgroup Meeting
On June 22, from 10 a.m. to 12 p.m., DHCS will virtually host the CalAIM Managed Long-Term Services and Supports (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 it allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Background materials, transcripts, and video recordings of the previous workgroup meetings, along with more 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.
Doula Implementation Workgroup Meeting
On June 23, from 10 a.m. to 12 p.m., DHCS will host a Doula Implementation Workgroup meeting to address the requirements of Senate Bill 65 (Chapter 449, Statutes of 2021) to examine the implementation of doula services as a covered Medi-Cal benefit. The meeting will focus on identifying barriers impeding access to doula services, recommending outreach efforts to help ensure Medi-Cal members are aware of the option to use doula services, and identifying and minimizing delays in payments to Medi-Cal doulas or in reimbursements to Medi-Cal members for services received.
The workgroup includes doulas, health care providers, consumer and community advocates, health plans, county representatives, and other stakeholders with experience in doula services. Information about the doula benefit is available on the DHCS webpage for doula services. A link for the public to listen to the meeting will be posted on that webpage by June 19. Written comments may be emailed to DoulaBenefit@dhcs.ca.gov.
Enhanced Care Management (ECM) for Children and Youth
On June 23, from 1 to 2:30 p.m., DHCS will host a virtual event (advance registration required) in advance of the launch of ECM for Children and Youth Populations of Focus (POF) on July 1. DHCS leaders will be joined by a panel of providers, community-based organizations (CBOs), and managed care plans (MCPs) to discuss:
- The design and operational guidance for the Children and Youth POF
- Examples of how providers are preparing to launch ECM for the Children and Youth POF
- Guidance to MCPs, counties, and other providers on contracting for the ECM benefit.
This webinar is open to the public, and attendees can ask questions. It will be of special interest to MCPs and providers working with children and youth, and for those who are new to contracting with MCPs, such as counties and CBOs. Please submit questions to CalAIMECMILOS@dhcs.ca.gov no later than June 19.
In Case You Missed It
California Awards $1.2 Million to Help Tribal Communities Address the Opioid Crisis
DHCS awarded $1.2 million to 11 organizations through the Tribal Local Opioid Coalition (TLOC). This project is funded by the State Opioid Response III grant awarded by the Substance Abuse and Mental Health Services Administration, and is part of DHCS' broader efforts to address substance use disorders, collectively known as the California MAT Expansion Project, to increase access to Medication Assisted Treatment (MAT). The 11 tribal organizations are receiving awards for the TLOC project from June 2, 2023, through June 20, 2024. Grantees are California tribal health organizations and entities that will work to increase access to treatment and will have access to a Tribal MAT Champion, who is a representative from the California Rural Indian Health Board serving as a subject matter expert on MAT. Awardees can contact this individual for ongoing support, including coaching, training, and technical assistance. Opportunities for peer-to-peer learning will be available through regional and statewide meetings and webinars.
Published COVID-19 Information
