Tsev Xov Xwm Txog Cov Neeg Muaj Feem Cuam Tshuam ntawm DHCS - Tsib Hlis 12, 2023​​ 

DHCS Stakeholder News – May 12, 2023​​ 

Xov xwm tshaj plaws​​  

Governor’s May Revision​​  

Governor Gavin Newsom proposed a $156 billion May Revision for DHCS programs and services for fiscal year 2023-24. It proposes to support vital services that reinforce the state’s commitment to preserve and improve the overall health and well-being of all Californians while operating within a responsible budgetary structure. Highlights include:​​  

Managed Care Organization (MCO) Tax and Medi-Cal Provider Rate increases. The May Revision includes the renewal of the MCO tax, effective April 1, 2023, nine months earlier than planned at Governor’s Budget. This earlier start results in approximately $3.7 billion in additional General Fund for calendar year 2023. Additionally, the May Revision increases MCO revenue (as compared to Governor’s Budget) to achieve an approximately $5 billion annual state benefit.
A portion of this revenue will support an increase in provider rates to at least 87.5 percent of Medicare for specified providers, including Primary Care (inclusive of nurse practitioners and physician assistants), Maternity Care (inclusive of OB/GYN and doulas), and non-specialty mental health services beginning January 1, 2024.
Additionally, in collaboration with key stakeholders in the Medi-Cal delivery system and with a focus on enhancing equitable access to care, DHCS will assess which ongoing, long-term rate augmentations will deliver the greatest benefit to improving Medi-Cal systems across California. The focus will be to look at additional augmentations to primary care, maternal care, and behavioral health as well as specialty care, outpatient, and acute care systems with attention on how to increase the commitment of providers to serve Medi-Cal members, support providers in disproportionately impacted areas, and build robust teams and programs with a strong workforce, to ensure care is provided in the right settings, at the right time, and at the highest quality. Following this process, DHCS will return with a proposed set of investments and augmentations that will be put forward to the Legislature in the 2024-25 Governor’s Budget, with an intended effective date of January 1, 2025. 
Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT). Formerly known as California Behavioral Health Community-Based Continuum (CalBH-CBC), the proposal continues to include the 1115 demonstration waiver to address the gaps in the behavioral health continuum of care for Medi-Cal members living with serious mental illness (SMI) and serious emotional disturbance (SED). The May Revision adds a new Workforce Initiative to the waiver, $480 million a year for the five years ($2.4 billion total funding), to strengthen the pipeline of behavioral health professionals, including improving short-term recruitment and retention efforts. 
Behavioral Health Modernization. The May Revision includes initial funding to support the behavioral health modernization proposal.​​  

Tej zaum Revision Budget Documents:​​ 

DHCS tshaj tawm Lub Npe Tshiab rau Kev Zam Kev Noj Qab Haus Huv​​  

DHCS is renaming the proposed California Behavioral Health Community-Based Continuum (CalBH-CBC) demonstration waiver to better align with the Department’s mission, vision, and goals. It will now be known as the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) waiver. The name change emphasizes DHCS’ commitment to providing a robust continuum of community-based behavioral health care services and improving equity, quality, and access for all Medi-Cal members living with SMI and SED, particularly populations experiencing disparities in behavioral health access and outcomes. The waiver name is new, but its objectives and approach remain the same.  

The waiver is informed by findings from DHCS’ 2022 report, Assessing the Continuum of Care for Behavioral Health Services in California, and is a historic opportunity to make significant investments in the full continuum of care for behavioral health, with a particular focus on the most vulnerable populations. For more information about this waiver, please visit the DHCS website.​​  

Kev hloov kho tshiab​​  

Daim Ntawv Qhia Txog Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Cov Pej Xeem (PNA)​​  

DHCS released a concept paper that outlines DHCS’ vision of a reimagined PNA that Medi-Cal managed care plans (MCPs) are required to complete. DHCS envisions a modified PNA that promotes greater alignment with local health departments and other community stakeholders, more robust community engagement, and a deeper understanding of member health and social needs and preferences and the communities in which they live. This approach will help target resources and interventions to support improved health outcomes for Medi-Cal members. DHCS encourages feedback on the concept paper through written comments and by participating in upcoming public forums and advisory groups. DHCS will accept public comment through 5 p.m. on June 2, 2023, to PHMSection@dhcs.ca.gov, with the subject line “Comments on PNA Concept Paper”.​​   

Along with the concept paper, DHCS will soon issue a new All Plan Letter (APL) to replace APL 19-011 and provide near-term MCP guidance on the modified PNA and the new population health management strategy. For more information and regular updates, please visit the CalAIM Population Health Management Initiative webpage.​​  

Health Enrollment Navigators Project​​   

Thaum Lub Tsib Hlis 12, DHCS tau ceeb toom rau cov neeg koom tes uas tau thov rau qhov tseem tsis tau muab faib rau Health Enrollment Navigator nyiaj pab ntawm $ 3.6 lab uas tsim nyog los ntawm Assembly Bill 74 (Chapter 23, Statutes of 2019) thiab Senate Bill 154 (Tshooj 43, Statutes of 2022). Cov nyiaj ntxiv no yuav ua rau cov neeg koom tes tsim kho tshiab tam sim ntawd, thiab ntxiv cov haujlwm uas twb muaj lawm, thiab cov xwm txheej cuam tshuam nrog Medi-Cal kev nthuav dav thiab Medi-Cal txuas ntxiv rau lub sijhawm tsis tu ncua. Cov koom haum hauv zej zog hauv zej zog txaus siab los pab nrog cov kev siv zog no tuaj yeem xa mus rau Cov Ntaub Ntawv Tus Tswv Cuab Hu rau ntawm Cov Neeg Koom Tes Hauv Cov Haujlwm ntawm DHCS lub vev xaib.​​  

Medi-Cal Rx Hloov tshiab​​  

Thaum Lub Tsib Hlis 19, Phase III, Lift 3 yuav raug muab coj los siv, nqa Txoj Cai Hloov Pauv rau 22 Standard Therapeutic Classes. Qhov no yog qhov thib peb nyob rau hauv ib tug series ntawm nqa mus rau theem tawm lub grandfathering ntawm keeb kwm yav dhau los tso cai ua ntej thiab thov los ntawm reinstating Reject Code 75 - Ua ntej tso cai yuav tsum tau.​​  

Smile, California Kev Sib Tw rau Medi-Cal Dental Services​​ 

Lub lim tiam ntawm lub Tsib Hlis 22, tsab ntawv xov xwm Smile Alert e-xov xwm txhua hli yuav raug xa mus rau txhua tus neeg siv npe ua lus ceeb toom rau cov tswv cuab Medi-Cal kom ua daim ntawv ntsuam xyuas 2023 Kev Pabcuam Tswvcuab Cov Neeg Siv Khoom. Tsab ntawv xov xwm tseem yuav hu xov tooj rau cov lus nug ntau nplooj ntawm SmileCalifornia.org, qhov twg Medi-Cal cov tswv cuab tuaj yeem nkag mus rau cov lus nug ntau txog Medi-Cal kev pab them nqi kho hniav.​​    

Family PACT Daim Ntawv Qhia Txhua Xyoo​​   

Thaum Lub Tsib Hlis 12, DHCS tau tshaj tawm Family Planning, Access, Care and Treatment (Family PACT) Txoj Kev Qhia Nyiaj Txiag Xyoo 2019-20 ntawm Family PACT lub vev xaib. Txoj cai lij choj yuav tsum muaj kev tshuaj xyuas txhua xyoo ntawm cov kev ntsuas tseem ceeb. Daim ntawv tshaj tawm txhua xyoo no yog ua raws li kev tso npe kawm thiab cov ntaub ntawv thov uas piav qhia txog Family PACT tus neeg muab kev pabcuam thiab cov neeg siv khoom, hom kev pabcuam siv, thiab kev them nyiaj rov qab rau qhov program. Hnub tim ntawm kev pabcuam hauv daim ntawv tshaj tawm no yog rau xyoo nyiaj txiag 2019-20, uas tau pib thaum Lub Xya Hli 1, 2019, thiab xaus rau lub Rau Hli 30, 2020.​​  

Koom nrog peb pab neeg​​    

DHCS is hiring! DHCS has an immediate opening for Deputy Director and Chief Counsel, Office of Legal Services. This executive role offers the right attorney an opportunity to lead DHCS’ legal team in providing comprehensive legal and regulatory services and advice regarding Medi-Cal and behavioral health.​​  

DHCS is also hiring for our fiscal, human resources, legal, auditing, health policy, communications, and information technology teams. For more information, please visit the CalCareers website.  ​​  

DHCS tau mob siab rau khaws cia thiab txhim kho kev noj qab haus huv thiab kev noj qab haus huv ntawm txhua tus neeg California. DHCS lub luag haujlwm yog los muab cov neeg nyob hauv lub xeev uas muaj kev pheej hmoo siab tshaj plaws kom muaj kev ncaj ncees rau kev pheej yig, kev sib koom ua ke, kev saib xyuas kev noj qab haus huv zoo, thiab tam sim no tab tom hloov kho Medi-Cal kev pab cuam kom paub tseeb tias nws muab kev saib xyuas cov neeg California xav tau kev noj qab haus huv, lub neej zoo siab dua. ​​  

Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej​​  

Dementia Care Aware – Cognitive Health Assessment (CHA) Virtual Training​​  

Pib txij lub Tsib Hlis 19, 2023, Dementia Care Aware tab tom muab kev cob qhia Zoom txhua hli (yuav tsum tau sau npe ua ntej) ntawm CHA, coj los ntawm cov kws kho mob geriatric ntawm University of California, Irvine. CHA yog ib qho kev tshuaj ntsuam xyuas dementia uas yuav tsum tau ua rau cov neeg laus laus thaum twg qhov kev ntsuam xyuas kev txawj ntse raug qhia. Cov kws kho mob thiab pab pawg yuav tsum koom nrog kev cob qhia thaum lub Tsib Hlis 19, thiab thawj hnub Friday thib peb ntawm txhua lub hlis tom qab ntawd, kom paub ntau ntxiv txog qhov kev ntsuam xyuas no tuaj yeem txhawb nqa cov kws kho mob thiab lawv pab pawg txhawm rau txhawm rau txheeb xyuas qhov dementia hauv lawv cov neeg mob zoo dua. Muaj kev kawm kho mob txuas ntxiv dawb thiab chav kawm txuas ntxiv.​​   

Hloov Kho Cov Cai thiab Cov Txheej Txheem rau Kev Sau Npe ntawm Medi-Cal Cov Kws Kho Hniav​​  

On May 22, from 1:30 to 3 p.m., DHCS will hold a public hearing via webinar (advance registration required) to discuss the regulatory provider bulletin entitled, “Updated Requirements and Procedures for the Enrollment of Medi-Cal Dental Providers.” Stakeholders can submit questions and suggestions during the hearing, and written comments will be accepted on the day of the hearing. Based on the public comments received, DHCS will publish the final bulletins on the Medi-Cal and DHCS websites. The changes will become effective 30 days after publication.​​   

For those who are unable to attend, written comments to be considered prior to publication may be submitted by 5 p.m. on May 22 to DHCSPEDStakeholder@dhcs.ca.gov. Please ensure the commenter and organization/association represented are identified in the comment.​​  

Stakeholder Advisory Committee (SAC) thiab Behavioral Health Stakeholder Advisory Committee (BH-SAC) Lub Rooj Sib Tham​​   

Thaum Lub Tsib Hlis 24, thaum 9:30 teev sawv ntxov txog 3:30 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham thib ob SAC thiab BH-SAC hybrid ntawm 2023 (yuav tsum tau sau npe ua ntej). Nws yuav qhib raws li lub rooj sib tham sib koom ua ke, nrog cov ncauj lus qhia los ntawm SAC thiab BH-SAC. Yuav muaj lub rooj sib tham BH-SAC nkaus xwb tom qab lub rooj sib tham sib koom ua ke; tsis muaj lub rooj sib tham SAC nkaus xwb. Cov neeg tuaj koom tuaj yeem tuaj koom tus kheej ntawm Lub Xeev California Endowment, nyob ntawm 1414 K Street hauv plawv nroog Sacramento, lossis zoo li. Yog xav paub ntxiv, thov mus saib hauv SAC thiab BH-SAC lub vev xaib.​​  

Cov Nqi Them Nqi Ua Haujlwm​​  

Nyob rau lub Tsib Hlis 25, txij li 1 txog 3 teev tsaus ntuj, DHCS, koom tes nrog Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DMHC), yuav ua kom zoo rau lub rooj sib tham plaub pawg neeg ua haujlwm (yuav tsum tau sau npe ua ntej) los tham txog kev txhim kho cov nqi them tag nrho hauv lub xeev rau kev pabcuam kev noj qab haus huv hauv tsev kawm ntawv raws li Children and Youth Behavioral Health Initiative. DHCS thiab DMHC yuav koom nrog cov koom tes sawv cev rau K-12 kev kawm, cov tsev kawm ntawv qib siab, Medi-Cal MCPs, cov phiaj xwm kev noj qab haus huv kev lag luam, cov chaw saib xyuas kev noj qab haus huv hauv nroog, cov chaw saib xyuas kev noj qab haus huv, cov koom haum, cov neeg tawm tswv yim, cov hluas, thiab cov niam txiv/cov neeg saib xyuas txog ntau txoj cai thiab cov ncauj lus qhia txog kev txhim kho thiab kho kom zoo ntawm qhov kev tsim qauv.​​     

Hauv Case Koj Tsis Tau Nws​​  

DHCS Director Michelle Baass’ Message on the End of the COVID-19 Public Health Emergency (PHE)  ​​  

DHCS expresses gratitude to our plans, providers, stakeholders, and other partners for their commitment and partnership during the COVID-19 PHE. We worked together and adapted quickly to the pandemic’s challenges and difficulties to care for millions of Californians. Our joint efforts enabled us to navigate the PHE with resilience and perseverance, and we are grateful for your ongoing engagement.  Read the full statement.​​   

Cov cuab yeej cawm txoj sia tshiab thiab cov peev txheej rau kev siv tshuaj tiv thaiv kev tsis sib haum xeeb, kho, thiab rov qab los​​  

On May 11, DHCS launched a partnership with national nonprofit Shatterproof to help combat the substance use crisis, keep Californians safe, and provide recovery resources to those in need. The new resources include Treatment Atlas, a confidential addiction treatment locator, assessment, and standards website platform that connects individuals and their families to appropriate evidence-based, high-quality addiction treatment. Additionally, to empower individuals and change attitudes about substance use disorders, DHCS launched Unshame California, a science-driven and content-based campaign that promotes anti-stigma messaging through stories of Californians impacted by substance use disorders. Both of these resources are available in English and Spanish.​​   

Tshaj tawm cov ntaub ntawv COVID-19​​