Xov xwm
Txhim Kho Kev Tswj Xyuas & Kev Txhawb Zej Zog | Kev hloov pauv ntawm Medi-Cal
Nplooj ntawv no ntes cov xov xwm tshiab tshaj plaws txog kev tswj hwm kev kho mob
Tam sim no muaj: Cov ntaub ntawv tshiab lees paub hauv zej zog txhawb kev txhim kho cov txiaj ntsig thiab txiav cov nqi
Hauv nws tsab xov xwm tshaj tawm rau lub Rau Hli 3, 2025 , DHCS tau hais txog cov ntaub ntawv txhawb nqa los ntawm Daim Ntawv Qhia Txog Kev Txhawb Nqa Hauv Zej Zog los qhia tias Kev Txhawb Nqa Hauv Zej Zog ua tiav thiab tsim nyog tus nqi. Cov ntaub ntawv qhia tau tias Community Supports ua raws li lawv cov lus cog tseg los daws cov kev xav tau ntawm cov tswv cuab Medi-Cal—txo kev mus ntsib chav kho mob ceev uas zam tau, kev nyob hauv tsev kho mob, thiab kev siv kev saib xyuas mus sij hawm ntev thaum qhia txog cov cim qhia tias txuag tau nyiaj thaum ntxov. Tag nrho 12 qhov kev txhawb nqa hauv zej zog uas tau kawm txog tab tom txo cov nqi, thiab ntawm cov no, cuaj twb tau ua pov thawj tias siv tau nyiaj tsawg hauv lub sijhawm kawm thawj zaug. Peb qhov seem seem yuav ncav cuag qhov ntsuas ntawd dhau lub sijhawm kawm ntev dua, raws li txoj cai tswjfwm tebchaws rau kev ntsuam xyuas kev siv nyiaj tsim nyog. Thov saib daim ntawv qhia txog Kev Txhawb Nqa Hauv Zej Zog no kom paub ntau ntxiv.
Kev Tso Tawm Tshiab ntawm Phau Ntawv Qhia Txog Txoj Cai Txhawb Nqa Zej Zog - Tam Sim No Muaj Nyob Hauv Ob Phau Ntawv
DHCS txaus siab los qhia txog Cov Kev Pabcuam Hauv Zej Zog Txoj Cai Qhia Tawm Tshiab, tshaj tawm rau lub Plaub Hlis 30, 2025.
To accommodate new policies related to Transitional Rent and other Community Supports for Members experiencing or at risk of homelessness, DHCS has reorganized the guide into two separate volumes:
- Volume 1 muaj cov lus txhais cov kev pab cuam rau yim ntawm Lub Zej Zog Txhawb nqa uas hais txog Cov Tswv Cuab cov kev xav tau kev noj qab haus huv ntsig txog kev noj qab haus huv, suav nrog plaub Cov Kev Pabcuam Zej Zog uas tau hloov kho yav dhau los los ntawm DHCS thaum Lub Ob Hlis 2025: Cov Khoom Noj Khomob Kho Mob / Cov Khoom Noj Kho Mob, Kev Kho Mob Kho Mob, Kev Pabcuam Nyob Hauv Kev Hloov Pauv thiab Kev Pabcuam Hauv Zej Zog lossis Tsev Hloov Kho.
- Volume 2 muaj cov ntsiab lus ntawm kev pabcuam rau xya qhov Kev Pabcuam Hauv Zej Zog ntxiv, suav nrog Kev Hloov Hloov Pauv, uas cuam tshuam txog vaj tse lossis muaj chav thiab pawg thawj coj saib xyuas, thiab tshwj xeeb yog tsim los txhawb cov tswvcuab uas muaj lossis muaj kev pheej hmoo ntawm kev tsis muaj tsev nyob.
Txhawm rau txhawb kev siv cov kev hloov tshiab no, DHCS tab tom tuav ob lub vev xaib xov xwm:
Sau npe rau Volume 1 Webinar: Friday, Tsib Hlis 16, 2025 | 11:00 Nws – 12:30 p.m. PT
Sau npe rau Volume 2 (Housing-specific) Webinar: Wednesday, May 14, 2025 | 12:00 – 01:30 PT
We encourage you to review both volumes of the guide and join us at the upcoming webinars. DHCS also encourages the public to visit the Medi-Cal ECM and Community Supports webpage for regular updates and the new DHCS Housing for Health webpage for housing-related updates from various DHCS initiatives both within and outside Medi-Cal.
Kev Tshaj Tawm Tshaj Tawm: Txhim Kho Kev Tswj Xyuas Kev Kho Mob thiab Kev Txhawb Zej Zog Txhawb Kev Ua Haujlwm Peb Hlis Lub Plaub Hlis mus txog Q2 2024
On December 20, 2024, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report covering data from January 2022 through June 2024. ECM provides high-touch, team-based care management for Medi-Cal members with complex needs, while Community Supports offer cost-effective, medically appropriate alternatives to traditional services, addressing social determinants of health like housing and nutrition. Together, these initiatives are critical to ensuring holistic, person-centered care that improves health outcomes and quality of life for Medi-Cal members. The report demonstrates sustained, quarter-over-quarter growth in both ECM and Community Supports use, as additional populations of focus become eligible for ECM and more services are offered across the state.
Daim ntawv tshaj tawm kuj tseem muab cov ntaub ntawv thawj zaug ntawm ECM cov tswv cuab hauv qhov kev qhia tshiab Kev Ncaj Ncees Kev Ncaj Ncees Kev Ncaj Ncees (POF) thiab Cov Tib Neeg Hloov Los ntawm Kev Raug Ncua POF, ob qho tib si tau tshaj tawm lossis nthuav tawm thaum Lub Ib Hlis 2024.
Key findings included 244,750 Medi-Cal members receiving ECM benefits, with 127,024 members served in Q2 2024. This represents a more than 50% increase in quarterly ECM members since Q2 2023. About 239,500 members used Community Supports services, and 89% of Medi-Cal members had access to at least 10 services. This represents a more than 120% increase in quarterly Community Supports members since Q2 2023. In Q2 2024, more than 59% of members using Community Supports accessed Medically Tailored Meals/Medically Supportive Foods, and approximately 35% accessed one or more services from the Housing Trio (Housing Transition Navigation Services, Housing Tenancy and Sustaining Services, and Housing Deposits).
Cov Cai Tshiab los Ua Kom Kev Nkag Mus Rau ECM Yooj Yim Dua
DHCS is releasing new policies that will streamline and improve access to ECM by standardizing referrals and expediting the authorization process. DHCS worked extensively with stakeholders to develop statewide ECM Referral Standards and an updated ECM presumptive authorization policy. Both policies take effect on January 1, 2025, and MCPs are currently operationalizing the new guidance. This adds to a series of reforms DHCS has made to streamline access to ECM and Community Supports outlined in the 2023 ECM/Community Supports Action Plan.
The ECM Referral Standards define the information all MCPs will collect via ECM referrals. Entities making referrals to ECM will submit the same information in their ECM referrals across counties and MCPs rather than navigating different information requirements across referral forms or batch templates. Additionally, MCPs may not require additional documentation (e.g., ICD-10 codes, supplemental checklists, or Treatment Authorization Request (TAR) forms) from referring partners or ECM providers beyond the information provided in the ECM referral to authorize ECM. The goal is to reduce barriers and burdens for referring entities and support DHCS’ goal that the majority of ECM referrals come from the community, which is also associated with increased ECM uptake.
DHCS is also releasing updated requirements for MCPs to expand the use of ECM presumptive authorization. Select ECM providers already contracted in an MCP’s ECM provider network will be able to directly authorize ECM for members and be paid for ECM services during a 30-day timeframe without waiting for an MCP’s authorization decision. ECM providers under presumptive authorization will still need to submit a referral to the MCP for full authorization within the 30-day timeframe. The goal is to ensure that select ECM providers can begin providing the ECM benefit immediately when they reach a member without waiting for authorization, which may delay services. For full details on the policy and eligible ECM Providers, please see the updated ECM Policy Guide.
Tsis tas li ntawd, thaum Lub Kaum Hli 9, thaum 11 teev sawv ntxov txog 12 teev tsaus ntuj PDT, DHCS yuav tuav ib qho All Comer Webinar los qhia cov ntsiab lus ntawm thoob plaws lub xeev ECM Cov Qauv Xa Ntawv thiab ECM txoj cai tso cai tso cai. Yuav tsum tau sau npe Advanced. Pawg neeg koom tes thiab cov neeg koom tes kuj tseem tuaj yeem xa cov lus nug txog cov lus qhia tshiab rau DHCS ntawm CalAIMECMILOS@dhcs.ca.gov.
Daim Ntawv Qhia Txog Kev Them Nqi Xauj Tsev Hloov Chaw ntawm CalAIM rau Cov Lus Qhia rau Pej Xeem
Thaum Lub Yim Hli 30, DHCS tau tshaj tawm Daim Ntawv Hloov Pauv Hloov Pauv Hloov Pauv rau pej xeem tawm tswv yim. Daim ntawv qhia lub ntsiab lus piav qhia txog kev tsim qauv ntawm Kev Rent Hloov Kho, ib qho kev pib tshiab nyob rau hauv California Advancing and Innovating Medi-Cal (CalAIM) Seem 1115 zam kev nthuav qhia los muab kev pab them nqi xauj tsev / tsev nyob ib ntus rau Medi-Cal cov tswv cuab uas tab tom ntsib lossis muaj kev pheej hmoo ntawm kev tsis muaj tsev nyob thiab ua tau raws li qee yam kev tsim nyog ntxiv. Kev pab them nqi xauj tsev raws li Kev Pabcuam Hauv Zej Zog yuav xaiv tau rau Medi-Cal cov phiaj xwm kev saib xyuas uas tau tswj xyuas pib thaum Lub Ib Hlis 1, 2025, thiab nws yuav yog qhov yuav tsum tau txais txiaj ntsig los ntawm txhua qhov kev npaj rau lub Ib Hlis 1, 2026. DHCS yuav nrhiav kev tawm tswv yim los ntawm ntau tus neeg muaj feem cuam tshuam ntawm daim ntawv tswv yim.
Txhawm rau txhim kho kev noj qab haus huv thiab kev noj qab haus huv ntawm cov tswv cuab ntawm Medi-Cal thaum muaj kev hloov pauv tseem ceeb lossis uas ua tau raws li qee qhov kev pheej hmoo siab, California nrhiav kev pabcuam txog rau rau lub hlis ntawm Transitional Rent services rau cov tswvcuab tsim nyog uas tsis muaj tsev nyob lossis muaj kev pheej hmoo ntawm kev tsis muaj tsev nyob thiab hloov tawm ntawm tsev kho mob theem, koom ua ke cov chaw nyob, cov chaw kho mob, cov tsev kho mob luv luv, kev saib xyuas menyuam yaus. vaj tse nyob, vaj tse nyob mus ib txhis, cov tsev tsis muaj vaj tse nyob, los yog vaj tse nyob ib ntus, nrog rau cov tswv cuab uas ua tau raws li cov txheej txheem rau kev tsis muaj vaj tse nyob los yog rau qhov kev pab cuam Full Service Partnership (FSP). Kev Rent Kev Pabcuam yuav raug muab tsuas yog yog tias nws tau txiav txim siab kho mob uas tsim nyog siv kev kho mob thiab lwm yam kev xav tau ntawm kev noj qab haus huv.
DHCS invites the public to comment on this concept paper. Comments are due by 5 p.m. PT, September 20, 2024. Comments may be submitted to CalAIMECMILOS@dhcs.ca.gov with the subject line “Comments on Transitional Rent.”
CalAIM rau Cov Neeg thiab Tsev Neeg uas Muaj Kev Tsis Muaj Tsev Nyob
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau tuav ib qho webinar rau txhua tus neeg los ntawm Kev Tswj Xyuas Kev Kho Mob (ECM) thiab Kev Pabcuam Zej Zog rau cov tib neeg thiab cov tsev neeg uas ntsib kev tsis muaj tsev nyob rau hnub Friday, Tsib Hlis 31 thaum 1:30–3:00 teev tsaus ntuj PT.
Hauv qhov webinar no, DHCS cov thawj coj tau koom nrog los ntawm pawg neeg saib xyuas los ntawm cov kws kho mob thiab cov kev tswj xyuas kev saib xyuas xa ECM thiab cov kev pab cuam hauv zej zog tseem ceeb. Lawv muab:
- Overviews of how ECM and Community Supports aim to address Members’ clinical and non-clinical needs;
- Kev pom los ntawm cov chaw muab kev pabcuam ntawm kev sib txuas Cov Tswvcuab rau Cov Kev Pabcuam Hauv Zej Zog tseem ceeb xws li Cov Nyiaj Them Nqi thiab Cov Kev Pabcuam Housing Transition Navigation Services thiab braiding ECM thiab Zej Zog Kev Pabcuam rau cov tib neeg thiab cov tsev neeg uas tsis muaj tsev nyob;
- Kev taw qhia rau cov neeg koom tes hauv zej zog thiab cov neeg muab kev pab cuam txog kev xa cov tib neeg thiab tsev neeg mus rau ECM thiab Kev Txhawb Zej Zog thiab koom nrog Cov Tswv Cuab uas ntsib kev tsis muaj tsev nyob hauv ECM thiab Kev Txhawb Zej Zog.
A recording, transcript and slides are available under the “Webinar & Meetings” tab. These materials will be of special interest to MCPs, providers, and organizations working with individuals and families experiencing homelessness, including counties and CBOs.
Kev Tshaj Tawm Tshaj Tawm: Txhim Kho Kev Tswj Xyuas Kev Kho Mob thiab Kev Txhawb Zej Zog Txhawb Kev Ua Haujlwm Peb Hlis mus txog Q2 2023
On January 29th, 2024, DHCS released its ECM and Community Supports Quarterly Implementation Report for Q2 2023. This report summarizes ECM and Community Supports implementation trends and data for the first 18 months of the programs, spanning January 2022 through June 2023. Similar to the 2022 Year One Implementation Report released last August, this report provides insight into state-, county-, and managed care plan-level data.
In the first 18 months, 140,886Medi-Cal MCP members across the state received the ECM benefit and 75,834 members received 167,960 Community Supports services. As California continues advancing its Medi-Cal transformation, ECM and Community Supports play a critical role in supporting whole-person care for Medi-Cal members with complex medical and health-related social needs. DHCS expects to see more enrollment growth across both programs in the coming months and years, including as additional Populations of Focus become eligible for ECM and additional Community Supports services are offered in counties across the state. DHCS remains committed to supporting and sustaining this growth through program monitoring, design improvements, and standardization.
Qhia Link: ECM thiab Zej Zog Txhawb Nqa Daim Ntawv Qhia Txog Kev Ua Haujlwm Peb Hlis (arcgis.com)
Hloov Kho Txoj Cai Qhia Tawm: Kev Txhawb Zej Zog
- In July 2023, DHCS released its updated Community Supports Policy Guide. These updates reflect the policy refinements discussed at the June 9th, 2023 Summit and cover key areas including eligibility, referrals and authorizations, provider networks, payment, market awareness, and data exchange.
Cov Teeb Pom Kev Zoo ntawm ECM
DHCS cog lus tias yuav muab kev pab txhawb nqa thiab kev txhawb nqa rau California lub network ntawm ECM Providers uas tab tom loj hlob, thiab tab tom tso tawm cov ECM Spotlights los muab cov lus qhia ntxiv txog seb Cov Kws Muab Kev Pab kho ECM li cas kom tau raws li qhov xav tau ntawm cov pej xeem sib txawv (POFs). Cov Chaw Qhia Txog Kev Ua Lag Luam no yog tsim los pab cov neeg cog lus thiab cov neeg yuav muab kev pabcuam ECM los tsim thiab txhim kho lawv cov qauv ECM.
- Thaum Lub Kaum Ob Hlis Ntuj xyoo 2025, DHCS tau tshaj tawm nws qhov ECM California Children's Services (CCS) Technical Assistance Resource Spotlight thiab cov slides uas nrog los: ECM CCS Resource Slides. Cov peev txheej no muab cov tswv yim los txheeb xyuas cov menyuam yaus uas tau txais cov kev pabcuam CCS uas yuav tau txais txiaj ntsig los ntawm ECM, txhawb kev koom tes ntawm CCS thiab cov pab pawg saib xyuas ECM, thiab tsim kom muaj peev xwm ntawm cov neeg muab kev pabcuam ECM los ua kom tau raws li cov kev xav tau tshwj xeeb ntawm cov menyuam yaus hauv CCS.
- Thaum Lub Ob Hlis Ntuj xyoo 2024, DHCS tau tso tawm nws daim ntawv qhia txog ECM rau Cov Neeg Tsis Muaj Tsev Nyob POF Spotlight. Qhov Spotlight qhia txog cov tswv yim los txuas ECM nrog Kev Txhawb Nqa Hauv Zej Zog kom txo qhov kev tsis muaj kev nyab xeeb ntawm cov tswv cuab.
- Thaum Lub Kaum Ib Hlis 2023, DHCS tau tshaj tawm nws qhov ECM rau Cov Menyuam Yaus thiab Cov Hluas POFs Spotlight uas lub hom phiaj yog txhawb nqa cov koom haum muab kev pabcuam uas tab tom xav txog seb kev muab ECM rau cov menyuam yaus thiab cov hluas puas yog rau lawv.
Cov Lus Nug Txog Kev Sib Luag ntawm Cov Neeg Yug Los Ntawm ECM
The ECM Birth Equity POF that launched on January 1, 2024 is one component of DHCS’ overall approach to improving prenatal and postpartum care and is aimed at addressing specific disparities in access to prenatal care and pregnancy-related mortality. In February 2024, DHCS released answers to frequently asked questions on Member eligibility and dual enrollment in additional Medi-Cal services for the ECM Birth Equity POF. Additional information can be found in DHCS ECM Policy Guide. DHCS welcomes additional questions via email at CalAIMECMILOS@dhcs.ca.gov.
Txheej txheem cej luam
Rub tawm cov ntsiab lus ntawm ECM thiab Zej Zog Txhawb Txoj Cai Hloov Tshiab rau cov neeg muab kev pabcuam thiab lwm tus neeg muaj feem cuam tshuam. Nws piav qhia txog cov cai tseem ceeb nrog rau qhov sib txawv ntawm lub xeev-txheej txheem cov cai thiab qhov twg muaj kev hloov pauv rau MCPs los txheeb xyuas lawv tus kheej cov cai thiab cov txheej txheem.