​​DHCS Stakeholder News - December 9, 2022​

DHCS​ is providing this update of significant developments regarding DHCS programs.

Top News

Correction to Cal MediConnect (CMC) Notice Sent in Error

In late November, DHCS mailed a Disenrollment Letter (DL) in error to CMC members in Los Angeles, Riverside, San Bernardino, San Diego, and Santa Clara counties. DHCS can confirm that members were not disenrolled early from their CMC plans and they do not need to take any action in response to this notice. The members will remain in their plans until December 31, 2022, and will be automatically enrolled, with no gap in coverage, into their affiliated Medicare-Medi-Cal Plan on January 1, 2023.

DHCS, through Health Care Options, is conducting an outbound call campaign to all members who received the letter, informing them to both disregard the notice sent in error and that there is no interruption to their current CMC plan.  

DHCS has posted all member notices and further information on the Future of Cal MediConnect webpage. Please send any questions to info@calduals.org.

Behavioral Health Continuum Infrastructure Program (BHCIP) Round 4: Children and Youth Grants

On December 7, DHCS awarded $480.5 million in funding to 54 behavioral health projects in California serving children, youth, transition-age youth, and pregnant and postpartum women. These awards are being made through the BHCIP Round 4: Children and Youth grants. BHCIP represents the largest provision of resources for mental health and/or substance use disorder infrastructure in the state's history, and an unprecedented opportunity to address historic gaps and effect meaningful, sustainable change in California's behavioral health continuum. Additional information about BHCIP Round 4: Children and Youth awardees is available at BHCIP Grant Award Information.

Providing Access and Transforming Health (PATH) Justice-Involved Round 2 Application Deadline Extended

DHCS has extended the application deadline for the California Advancing and Innovating Medi-Cal (CalAIM) PATH Justice-Involved Round 2 funding to March 31, 2023. The Third Party Administrator (TPA) for the PATH initiative is integrating application updates from ACWDL 22-27 published on November 10, 2022, into the Round 2 application. The Justice-Involved Round 2 application will be taken offline until January 25, 2023 to complete the application updates. Anyone currently working on an application should wait to submit it when the application reopens on January 25. Additional information will be provided as soon as possible.

Please email justice-involved@ca-path.com with any questions about the Round 2 application extension.

Medi-Cal Rx Prior Authorization (PA) Requirements

DHCS has begun meeting with Medi-Cal Rx stakeholders (managed care plans, pharmacy providers, prescribers, hospitals, and member advocates and their respective associations) to present information on the final three phases for the reinstatement of PA requirements and retirement of the Transition Policy.

  • By February 24, 2023, all PA requirements will be reinstated for adult members ages 22 and older receiving new start medications.
  • By June 23, 2023, the Transition Policy for grandfathered PAs for adults ages 22 and older will be phased out.
  • The final phase will reinstate PA requirements while retiring the Transition Policy for children ages 21 and younger, as well as for enteral nutrition products.

DHCS has presented the timelines and scope of each phase, including the impact of the policy changes to members of Medi-Cal, California Children's Services (CCS), Genetically Handicapped Persons Program, and Early and Periodic Screening, Diagnostic, and Treatment. DHCS will continue to engage stakeholders throughout the process.

Telehealth: Member Informational Notice

DHCS composed a draft Member Informational Notice for public comments due by December 16. The member notice will be shared in 2023, notifying members of available telehealth services and informing them of their right to:

  • Access covered health care services through a visit with a health care provider other than telehealth. 
  • Choose telehealth as a modality.
  • Receive transportation services to a health care appointment.
  • Be informed of the limitations/risks associated with using telehealth.
  • File complaints related to telehealth.

Comments can be emailed to Medi-Cal_Telehealth@dhcs.ca.gov.

Program Updates

Long-Term Services and Supports (LTSS) Dashboard

On December 12, DHCS will launch the LTSS Data Dashboard, an initiative of the Home and Community-Based Services (HCBS) Spending Plan . The dashboard will track demographic, utilization, quality, and cost data related to LTSS. It will include statewide nursing home and HCBS data, with the goal of increased transparency to make it possible for regulators, policymakers, and the public to be informed while the state continues to expand, enhance, and improve the quality of LTSS in all home, community, and congregate settings.

The LTSS dashboard will be launched using a phased approach, and the initial data will include 38 measures focused on utilization. Additional measures will be added on a flow basis over the coming months. Future iterations of the dashboard will enhance data visualization capability and add data about quality and cost.

This initial release of the dashboard shows that California continues to have a strong rate of LTSS “rebalancing", otherwise known as HCBS utilization, compared to overall LTSS use. This is due to the state's robust array of HCBS programs. In 2021, 85 percent of Medi-Cal members that used LTSS services used HCBS; only about 15 percent of LTSS members stayed in a long-term care (LTC) facility, but did not use HCBS.

This release also shows an increase in HCBS utilization each year, as well as a decline in average monthly census and overall use of LTC facilities in 2020 and 2021 due to the impact of the COVID-19 pandemic.

Coming Soon: Accepting Applications for Clinic Workforce Stabilization Retention Payments (CWSRP)

On December 29, DHCS will begin accepting applications for CWSRP. All successfully registered qualified clinics will receive a link to the application for submitting employee information. All requests for payment must be submitted no later than 5 p.m. on January 27, 2023. DHCS encourages early submissions so that all applications can be validated before the final due date. Additional application guidance and templates for submission will be posted on the CWSRP webpage on or before the opening of the application period.

In addition, DHCS is reminding all eligible qualified clinics to register for CWSRP, as registration closes on December 20, 2022. Updated Frequently Asked Questions (FAQs) have been posted. For guidance and a link to register, please visit the CWSRP webpage.

Application Deadline for Hospital and Skilled Nursing Facility (SNF) COVID-19 Worker Retention Payments (WRP)

DHCS is reminding all successfully registered Covered Entities (CEs), Covered Services Employers (CSEs), Physician Group Entities (PGEs), and Independent Physicians to submit their applications for the Hospital and SNF WRP. All requests for payment must be submitted no later than 5 p.m. on December 30, 2022. DHCS encourages early submissions so all applications can be validated shortly after the application submission deadline. If you are a CE, CSE, PGE, or an Independent Physician and you have not yet registered, please visit the WRP webpage to register by December 21, 2022.

For registration and application guidance, an application video tutorial, and all other supporting information, please visit the WRP webpage.

CMS Approves California's HCBS Spending Plan Quarterly Reports

On November 29, CMS approved DHCS' quarterly reports for California's HCBS Spending Plan for Quarters 1 and 2 of federal fiscal year 2022-23. California remains in compliance with program requirements, set forth in CMS' State Medicaid Director Letters #21-003 and #22-002. Under the American Rescue Plan Act of 2021, the HCBS Spending Plan permits California to receive a temporary 10 percentage point increase to the Federal Medical Assistance Percentage for certain Medicaid expenditures for HCBS. The approved quarterly reports and more information are available on the HCBS Spending Plan webpage.

Preadmission Screening and Resident Review (PASRR) Pilot Testing for Online System

On December 1, DHCS began a pilot project to allow general acute care hospitals (GACHs) to test PASRR's online system. The initial pilot group consists of six GACHs, and testing will be facilitated from December 1, 2022, through January 31, 2023. The remaining GACHs will be enrolled by region from February through April 2023.

PASRR is a federal and state-mandated program designed to identify evidence of a serious mental illness, intellectual and/or developmental disability, or related condition in all individuals (regardless of insurance type), who are seeking admission to a skilled nursing facility (SNF). To comply with federal regulations, the PASRR process must be completed prior to a beneficiary being admitted to a SNF.

DHCS is required to be fully compliant with California's PASRR process by July 1, 2023. To achieve this, all GACHs will be enrolled in PASRR's online system and must incorporate the PASRR screening protocol in their discharge process. The online system will streamline their efforts to complete the PASRR process before discharging a member to a Medicaid-certified SNF. For more information, visit the PASRR webpage.

Hearing Aid Coverage for Children Program (HACCP) Eligibility Expansion

Beginning January 1, DHCS welcomes newly eligible young adults ages 18 to 20 who meet other program criteria and need coverage for their hearing aid(s) and related services to apply for HACCP enrollment. Also, effective January 1, applicants under age 21 who meet program eligibility requirements may apply to enroll in HACCP even if they have partial other health coverage for hearing aids subject to a coverage limit of $1,500 or less per year. Additional program information is available on the HACCP webpage. Families can apply to enroll for coverage through HACCP's Online Application Portal.

Join Our Team

DHCS is hiring! We are searching for three mission-driven, motivated individuals to serve as Value-Based Payment Branch Chief, Quality and Health Equity Evaluation and Monitoring Branch Chief, and Quality & Health Equity Transformation Branch Chief for the Quality and Population Health Management Program. These Public Health Medical Administrator I positions will help DHCS serve the most vulnerable Californians.

DHCS is also hiring Californians to join 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. DHCS' mission is to provide the most vulnerable residents with access to affordable, integrated, high-quality, and equitable health care, and is currently transforming the Medi-Cal program to ensure it provides the care Californians need to live healthier, happier lives.

Upcoming Stakeholder Meetings and Webinars

Dementia Care Aware Webinar

On December 13, from 12 to 1 p.m., DHCS' Dementia Care Aware will virtually host the “Next Steps in Assessment and Management After a Positive Cognitive Health Assessment (advance registration required)" webinar. The webinar will include an update on next steps in assessment and management after a positive cognitive health assessment. 

Participants of the live webinar are eligible to receive 1 Continuing Medical Education (CME) and California Marriage and Family Therapists (CAMFT) credit. Providers are also encouraged to take the cognitive health assessment training (1.5 CME/CAMFT credit)  Additional information about the Dementia Care Aware Initiative is available at www.dementiacareaware.org.

CalAIM Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup December Meeting

On December 15, from 10 a.m. to 12 p.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). Agenda items include a summary of January 2023 enrollment changes, an overview of the 2024 Dual Eligible Special Needs Plans (D-SNP) care coordination guidance on palliative care, an update on the long-term services and supports dashboard, an update on the recently released 2023 CalAIM D-SNPs policy guide chapters, and a review of the January 2023 skilled nursing facility long-term care carve-in transition.

Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. Please email your questions to DHCS at info@calduals.org.

CalAIM Screening and Transition of Care Tools for Medi-Cal Mental Health Services

On December 15, from 3 to 4 p.m., DHCS will hold a webinar (advance registration required) for stakeholders to learn about the Screening and Transition of Care Tools for the Medi-Cal Mental Health Services initiative, which goes live on January 1, 2023, as part of CalAIM. This initiative is focused on developing statewide screening and transition of care tools for both adults and individuals under age 21 for use by county mental health plans (MHP) and Medi-Cal MCPs. The webinar will review timelines and expectations for implementation, highlight steps MCPs and MHPs can take to support a successful launch, and address frequently asked questions. Please email BHCalAIM@dhcs.ca.gov with any questions.

Nursing Facility Financing Reform Webinar

On December 21, from 3 to 4 p.m., DHCS will host a virtual stakeholder meeting to discuss the Workforce and Quality Incentive Program (WQIP), authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will present final program design of the WQIP and provide further opportunities for stakeholder feedback. Information about how to join the December 21 webinar will be posted on the Nursing Facility Financing Reform AB 186 webpage closer to the meeting date.

Published COVID-19 Information

Last modified date: 1/23/2023 2:58 PM