Cov Kev Cai Rau Cov Neeg Laus-raws li kev coj ua
In December 2024, the Centers for Medicare & Medicaid Services (CMS) approved SPAs 24-0042, 24-0051, and 24-0052, establishing Assertive Community Treatment (ACT), Forensic ACT (FACT), Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP), Clubhouse Services, Enhanced Community Health Worker (CHW) Services, and Individual Placement and Support (IPS) Supported Employment as covered Medi-Cal services.
County behavioral health delivery systems have the option to cover one or more BH-CONNECT EBPs within the Specialty Mental Health Services (SMHS), Drug Medi-Cal (DMC), and/or Drug Medi-Cal Organized Delivery System (DMC-ODS) programs.
Visit Opt in to BH-CONNECT to learn more about how to participate in optional BH-CONNECT activities, including adult EBPs, and BH-CONNECT Resources for federal approvals and policy guidance related to BH-CONNECT EBPs.
Assertive Community Treatment (ACT):
- ACT txhawb cov tswv cuab uas nyob nrog kev xav tau kev noj qab haus huv thiab kev coj cwj pwm tseem ceeb thiab keeb kwm kev kho mob uas yuav suav nrog kev mus pw hauv tsev kho mob puas hlwb thiab mus ntsib chav xwm txheej ceev, kev kho mob hauv tsev, kev koom tes nrog kev ua txhaum cai lij choj, kev tsis muaj tsev nyob, thiab / lossis tsis muaj kev koom tes nrog cov kev pab cuam sab nraud.
- ACT txhawb kev rov qab los ntawm kev pab cov tswv cuab daws cov tsos mob ntawm lawv tus cwj pwm kev noj qab haus huv thiab tau txais cov txuj ci uas lawv xav tau los ua haujlwm thiab koom nrog hauv zej zog.
- ACT is provided by a multidisciplinary team that typically consists of a psychiatrist, nurse, peer support specialists, and other behavioral health practitioners.
- Thaum xa mus rau kev ncaj ncees, ACT ua rau kev txhim kho kev noj qab haus huv thiab kev sib raug zoo, suav nrog cov tsos mob ntawm kev puas siab puas ntsws, tsawg dua cov neeg mob hauv tsev kho mob thiab chaw kho mob xwm txheej ceev, thiab nce kev koom ua ke nrog thiab kev koom tes hauv zej zog.
Forensic ACT (FACT):
- FACT adapts the ACT model to address the complex needs of members with significant behavioral health needs who are also involved with the criminal justice system.
- Los ntawm kev hais txog kev pheej hmoo thiab kev xav tau kev ua phem, FACT tau pom tias yuav txhim kho kev ua haujlwm thiab txo kev mus pw hauv tsev kho mob, tsis muaj tsev nyob, raug kaw, thiab ua txhaum cai ntawm kev ua txhaum cai thiab raug kaw ntawm cov tswvcuab rau npe.
- FACT complements other DHCS initiatives designed to better meet the needs of members who are justice-involved, such as the CalAIM Justice-Involved Reentry Initiative.
Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP)
- CSC supports members experiencing an initial episode of psychosis.
- CSC txhawb kev rov qab los ntawm kev muab kev txhawb nqa raws sijhawm thiab kev sib koom ua ke thaum lub sijhawm pib tseem ceeb ntawm kev puas siab puas ntsws los pab cov tswvcuab daws cov tsos mob ntawm lawv lub hlwb kev noj qab haus huv thiab ua haujlwm thiab koom nrog hauv zej zog.
- CSC includes a wide range of individualized supports that are provided by a multidisciplinary team of licensed and non-licensed mental health practitioners.
- Kev koom nrog CSC tau pom tias txo qhov yuav raug mus pw hauv tsev kho mob puas siab puas ntsws, mus rau chav kho mob ceev, chaw kho mob hauv tsev, kev koom nrog hauv txoj cai lij choj txhaum cai, kev siv tshuaj yeeb dej cawv, thiab kev tsis muaj tsev nyob, thiab ua rau muaj kev puas siab puas ntsws thiab lub neej zoo dua.
Kev Tso Npe Rau Tus Kheej thiab Kev Txhawb Nqa (IPS) Txhawb Kev Ua Haujlwm:
- IPS supports individuals living with behavioral health needs in obtaining and sustaining competitive employment to support their recovery.
- Cov tswv cuab ua haujlwm nrog pab pawg kws tshaj lij ua haujlwm hauv lawv qhov kev tshawb nrhiav haujlwm thawj zaug thiab muaj kev nkag mus rau kev txhawb nqa txuas ntxiv mus ntxiv thaum ua haujlwm tau ruaj ntseg.
- IPS tau raug khi rau kev txhim kho kev hwm tus kheej, kev koom nrog hauv zej zog, txo qis hauv kev tsis muaj tsev nyob thiab kev koom nrog kev ua txhaum cai lij choj, thiab kev txhim kho tag nrho lub neej zoo ntawm cov tib neeg nyob nrog kev coj tus cwj pwm noj qab haus huv.
Enhanced Community Health Worker (CHW) Services:
- Enhanced CHW yog cov kev pab tiv thaiv tiv thaiv kab mob, kev tsis taus, thiab lwm yam kev noj qab haus huv los yog lawv txoj kev loj hlob; ua kom lub neej ntev; thiab txhawb kev noj qab haus huv ntawm lub cev thiab tus cwj pwm.
- Enhanced CHW Services include all of the same service activities and practitioner requirements as other Medi-Cal CHW Services, but are tailored to Medi-Cal members who meet the access criteria for SMHS, DMC and/or DMC-ODS services.
Clubhouse Services:
- Clubhouses are inclusive, community-based environments to help members living with behavioral health needs build emotional, cognitive, and social skills. Clubhouses facilitate opportunities to build skills and relationships to support members in autonomous employment, education, and housing.
- Members work alongside Clubhouse staff as equals to contribute to shared community needs. Clubhouses offer employment programs and provide structured opportunities for socialization and recreation on evenings, weekends, and holidays.