Division Directory
Director’s Office
The Director’s Office oversees the organizational purpose of DHCS—to provide equitable access to quality health care leading to a healthy California for all. Coordinating with all programs and divisions of DHCS, the Director’s Office is responsible for policy setting, oversight, and decision making regarding DHCS services, programs and initiatives. The Directorate comprises the Director; Chief Deputy Director, Policy and Program Support; Chief Deputy Director, Health Care Programs; Chief Operating Officer for Programs; Assistant Director; and the State Medicaid Director.
Legislative thiab Governmental Affairs (LGA)
LGA facilitates, coordinates, and advocates for the development, refinement, and enactment of policy and budget legislation in the interest of public health and the state’s health care laws. LGA consults with other DHCS programs and divisions/offices and offers technical assistance to California state legislators and their staff on constituent issues. Additionally, LGA provides information about DHCS’ programs and services through briefings, testimonies at informational hearings, and meetings.
Office of Communications (OC)
OC yog lub luag haujlwm rau DHCS kev sib txuas lus tsim los koom nrog kev tshaj xov xwm, pej xeem, cov koom haum cuam tshuam nrog, cov neeg muaj feem cuam tshuam, thiab lwm pab pawg neeg nyiam DHCS cov txheej txheem. OC tswj hwm DHCS cov xov xwm thiab kev kawm rau pej xeem thiab nthuav tawm cov dej num thiab saib xyuas nws lub vev xaib thiab kev tshaj xov xwm, tswj nws cov ntsiab lus, nkag mus tau, thiab siv tau.
Office of Civil Rights (OCR)
OCR tswj hwm thiab tswj hwm cov cai lij choj pej xeem kom ntseeg tau tias tsis muaj kev ntxub ntxaug hauv txhua yam ntawm kev nkag mus thiab xa cov kev pabcuam kho mob muab lossis tswj hwm los ntawm DHCS.
Chaw Ua Haujlwm Ua Raws Cai
The Office of Compliance aims to strengthen DHCS’ compliance with federal and state laws and regulations by standardizing our approaches for tracking state and federal program requirements, identifying risks, and correcting deficiencies. The Office is responsible for managing, implementing, and leading the Department’s internal audits and coordinating waiver submissions to Centers for Medicare & Medicaid Services.
Office of Legal Services (OLS)
OLS provides comprehensive legal services to DHCS’ programs and employees. Services include preventive legal advocacy, legislative and policy advice, legal and litigation strategy, Public Records Act request coordination, and litigation support on DHCS matters to the Attorney General’s Office. OLS’ Office of Regulations and Administrative Services assists DHCS programs with developing and promulgating regulations and other rulemaking activities.
Strategic Planning and Workforce Development Division (SPAWDD)
SPAWDD delivers strategies that contribute to DHCS’ organizational effectiveness; identifies, develops, and implements initiatives to enhance the culture and support DHCS’ purpose; and oversees DHCS’ strategic and workforce and succession plans, enterprise governance, and workforce development.
Behavioral Health (BH)
BH leads DHCS’ ambitious agenda to ensure high-quality and accessible specialty mental health and substance use disorder services in Medi-Cal and other public programs. Behavioral Health develops and implements policies and initiatives to strengthen behavioral healthcare access, quality, and service delivery, and achieve equitable healthcare outcomes for Medi-Cal members and Californians served through other programs. BH includes California Behavioral Health Planning Council as well as the Community Services, Licensing, and Certification, Behavioral Health Oversight and Monitoring, and the Medi-Cal Behavioral Health – Policy Divisions.
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California Behavioral Health Planning Council (CBHPC)
CBHPC yog feem ntau ntawm cov neeg siv khoom thiab cov tswv cuab hauv tsev neeg pab tswv yim rau lub xeev thiab tsoomfwv hauv nroog, Pawg Neeg Cai lij choj, thiab cov neeg nyob hauv California txog kev pabcuam kev puas hlwb hauv California.
Kev Pabcuam Hauv Zej Zog (CSD)
CSD implements and oversees various behavioral health programs and services for adults, youth, and children. CSD certifies, oversees, and monitors adult and children’s residential mental health programs and provides oversight of the use of funds from opioid settlements by the state, counties, and local jurisdictions. CSD also administers several federal grants and oversees behavioral health prevention and family services and Proposition 64 youth substance use disorder prevention funding.
Licensing and Certificate Division (LCD)
Cov ntawv tso cai LCD tau lees paub, thiab saib xyuas cov kev siv tshuaj yeeb dej caw, suav nrog cov kev pab cuam tsav tsheb, cov kev pab cuam kho mob narcotic, cov koom haum counselor-certification, cov neeg mob haus cawv thiab/lossis lwm cov kev pab cuam tshuaj, thiab cov chaw kho mob hauv tsev. LCD kuj tso cai thiab saib xyuas 24-teev kev puas siab puas ntsws thiab kho cov chaw kho mob thiab ua kom muaj kev ua raws li cov kev pabcuam kev ncaj ncees thoob plaws lub xeev.
Tus Cwj Pwm Saib Xyuas Kev Noj Qab Haus Huv thiab Saib Xyuas Tus Cwj Pwm (BHOMD)
The Behavioral Health Oversight and Monitoring Division (BHOMD) monitors and oversees County Behavioral Health Plans to ensure compliance with state and federal requirements, regulations, and DHCS contract terms for the Specialty Mental Health Services (SMHS), Drug Medi-Cal (DMC), and Drug Medi-Cal Organized Delivery System (DMC-ODS) programs. Other responsibilities within the division include monitoring processes for Medi-Cal, Behavioral Health Services Act (BHSA), Mental Health Block Grant (MHBG), and Substance Use Block Grant (SUBG). BHOMD is also responsible for overseeing and monitoring the implementation of county BHSA-funded programs. BHOMD additionally oversees the implementation and reporting of quality requirements and the network adequacy of SMHS and DMC-ODS programs.
Medi-Cal Tus Cwj Pwm Kev Noj Qab Haus Huv - Txoj Cai Divisi-on (MCBHPD)
MCBHPD saib xyuas cov cai thiab cov haujlwm hauv cheeb tsam ntawm Cov Kev Pabcuam Kev Mob Siab Tshwj Xeeb, Tshuaj Medi-Cal, thiab Tshuaj Kho Mob Medi-Cal Organized Delivery System cov kev pab cuam. Nws saib xyuas Lub Xeev Txoj Kev Hloov Kho rau Lub Zos Cov Kev Npaj Noj Qab Haus Huv; California Advancing and Innovating Medi-Cal (CalAIM) kev txhim kho kev noj qab haus huv thiab kev coj cwj pwm; 988 kev kub ntxhov; Medi-Cal Mobile Crisis Services tau txais txiaj ntsig; Txoj Cai Pabcuam Hauv Zej Zog, Rov Qab Los, thiab Txhawb Txoj Cai (CARE); Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Ua qauv qhia; thiab Cov Kev Pabcuam Rov Qab Los (Kev Tswj Xyuas Thaum Muaj Xwm Ceev).
Health Care Benefits and Eligibility (HCBE)
HCBE provides leadership for benefits and eligibility policy planning, development, implementation, and evaluation of health care services and delivery systems under Medi-Cal and for the Children’s Health Insurance Program (CHIP). HCBE includes Medi-Cal Benefits, Medi-Cal Dental Services, Medi-Cal Eligibility, Office of Family Planning, Office of Tribal Affairs, and Pharmacy Benefits.
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Cov txiaj ntsig Division
Lub Tsev Haujlwm Saib Xyuas Kev Pabcuam tswj hwm thiab ua kom muaj kev sib koom ua ke ntawm tsoomfwv thiab lub xeev cov cai thiab cov cai hais txog Medi-Cal cov txiaj ntsig, kev pabcuam, thiab cov cai cuam tshuam rau Medi-Cal cov kws khomob thiab cov tswvcuab.
Medi-Cal Dental Services Divi-sion (MDSD)
MDSD tswj hwm Medi-Cal Dental Services Program rau ob qho tib si tus nqi-rau-kev pabcuam thiab cov qauv kev saib xyuas kho hniav uas tswj xyuas kev kho hniav. MDSD tsim thiab siv txoj cai tswjfwm txog kev muab kev pabcuam kho hniav rau cov tswvcuab Medi-Cal.
Medi-Cal Eligibility Division (MCED)
MCED tsim cov cai tswj kev tsim nyog, cov txheej txheem, thiab cov cai tswj hwm Medi-Cal thiab CHIP thiab ua kom ntseeg tau tias kev tsim nyog tau txais Medi-Cal raug txiav txim kom raug thiab raws sij hawm raws li lub xeev thiab tseem fwv cov cai. MCED kuj tseem muab cov nroog nrog cov kev tswj hwm nyiaj txiag los ua cov haujlwm tsim nyog thiab ua kom cov kev siv nyiaj hauv lub nroog rov zoo li peb lub hlis twg.
Office of Family Planning (OFP)
OFP administers the Family Planning, Access, Care, and Treatment Program, which has been operating since 1997 to provide family planning and reproductive health services at no cost to California’s uninsured/under-insured, low-income (under 200 percent of the federal poverty level) residents of reproductive age.
Office of Tribal Affairs (OTA)
OTA ua lub luag haujlwm tseem ceeb los pab txhawb kev koom tes ntawm DHCS cov kev pabcuam thiab pab pawg neeg thiab cov neeg sawv cev pabcuam kev noj qab haus huv Indian thiab cov koom haum hauv nroog Indian.
Pharmacy Benefits Division (PBD)
PBD teeb tsa txoj cai thiab kev pab them nqi kho mob rau cov chaw muag tshuaj kho mob sab nraud rau Medi-Cal qhov kev pab cuam. Qhov no muaj xws li kev ntsuam xyuas ntawm Medi-Cal Rx, ib tug nqi kho mob-nyiaj teg num, thiab raws li invoicing rau thiab sau los ntawm tsoom fwv teb chaws thiab lub xeev cov tshuaj rebates. PBD kuj teev txoj cai thiab administers cov kev kho mob outpatient mov thiab khoom noj khoom haus thiab cov kev pab cuam medi-Cal Vision Care.
Health Care Delivery Systems (HCDS)
HCDS tsim, siv, thiab saib xyuas kev noj qab haus huv rau cov tswv cuab ntawm Medi-Cal los ntawm kev tswj xyuas, kev sib koom ua ke ntawm kev saib xyuas, thiab kev coj tus cwj pwm kev noj qab haus huv. HCDS suav nrog Integrated Systems of Care, Managed Care Operations, thiab Managed Care Quality and Monitoring Divisions.
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Integrated Systems of Care Division (ICSD)
ISCD oversees, operates, and monitors compliance of comprehensive health care delivery systems for vulnerable populations eligible for various DHCS programs, such as the California Children’s Services, Genetically Handicapped Persons, and Waiver programs. ISCD also supports other programs serving populations, predominantly children, with complex chronic health conditions.
Managed Care Operations Division (MCOD)
MCOD saib xyuas cov kev pab cuam thiab cov dej num ua haujlwm los muab kev kho mob rau cov tswv cuab Medi-Cal uas tau muab rau hauv ib txoj kev npaj saib xyuas. MCOD tsom mus rau kev cog lus kev tswj hwm cov phiaj xwm kev noj qab haus huv uas ua haujlwm raws li 6 tus qauv tseem ceeb ntawm kev tswj hwm kev saib xyuas thiab saib xyuas cov haujlwm hloov pauv uas tsim nyog thaum hloov cov pej xeem mus rau hauv kev tswj hwm.
Managed Care Quality and Monitoring Division (MCQMD)
MCQMD saib xyuas thiab saib xyuas Medi-Cal cov phiaj xwm kev saib xyuas, Medi-Cal thiab Medicare Dual Tsim Nyog Cov Kev Xav Tau Tshwj Xeeb, thiab Medi-Cal tswj hwm txoj cai saib xyuas thiab txhais lus kom tau raws li cov tswv cuab Medi-Cal xav tau.
Health Care Financing (HCF)
HCF tau teeb tsa txoj cai nyiaj txiag rau Medi-Cal qhov kev pab cuam, suav nrog rau cov nqi-rau-kev pabcuam, kev saib xyuas, thiab kev coj tus cwj pwm kev noj qab haus huv; county- thiab tsev kawm ntawv cov kev pab cuam; thiab kev pabcuam kev pabcuam kev nyab xeeb. HCF suav nrog Capitated Rates Development, Tus Nqi-rau Kev Pabcuam Tus Nqi Kev Txhim Kho, Kev Pabcuam Hauv Nroog, thiab Kev Pabcuam Nyiaj Txiag Saib Xyuas Kev Nyab Xeeb.
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Capitated Rates Development Division (CRDD)
CRDD tsim thiab siv tus nqi them rau Medi-Cal cov kev npaj khomob, Medi-Cal Dental tswj cov kev npaj khomob, thiab Txoj Haujlwm Pabcuam Kev Pabcuam Rau Cov Neeg Laus, ua raws li lub xeev, tseemfwv qibsiab, thiab daim ntawv cog lus. CRDD tseem ua cov kev tshuaj xyuas nyiaj txiag, saib xyuas, thiab saib xyuas cov phiaj xwm los ntsuas kev noj qab haus huv nyiaj txiag thiab kev muaj peev xwm ntawm txhua txoj kev npaj.
Tus Nqi-rau-Service Rates Development Division (FFSRDD)
FFSRDD txhim kho Medi-Cal cov nyiaj them rov qab rau cov neeg mob sab nraud thiab cov kev pabcuam tsis yog hauv tsev khomob thiab kev saib xyuas mus sij hawm ntev uas tau them rov qab los ntawm Medi-Cal tus nqi-rau-kev pabcuam. FFSRDD sawv cev rau DHCS txog cov teeb meem ntsig txog Medi-Cal tus nqi teeb tsa hauv kev sib tham thiab/lossis cov rooj sib tham nrog cov neeg sawv cev kho mob, cov neeg tawm tswv yim, cov koom haum sab nrauv, cov neeg sawv cev ntawm lub nroog, xeev, thiab tsoomfwv, cov neeg sawv cev hauv kev lag luam, pab pawg tshwj xeeb, thiab lwm yam. cov nom tswv theem siab.
Local Governmental Finance Division (LGFD)
LGFD provides management and oversight of all county and local government federal reimbursement and financial oversight activities critical to ensuring access to high-quality and cost-efficient health care through DHCS’ contracted local governmental agencies. These agencies provide behavioral health care coverage and reimbursement to counties and/or school districts for administrative activities, targeted case management, and certain medically necessary school-based services.
Safety Net Financing Division (SNFD)
SNFD administers payment programs authorized in the Medicaid State Plan and Medicaid Section 1115 waivers using a variety of financing arrangements to maximize provider reimbursements and reduce their uncompensated care costs. SNFD also administers other programs to ensure access to care for California’s most vulnerable populations.
Quality and Population Health Management (QPHM)
QPHM ua rau kev kho mob zoo, kev muaj vaj huam sib luag kev noj qab haus huv, thiab kev noj qab haus huv pej xeem ua haujlwm txhawm rau txhim kho kev noj qab haus huv thiab kev saib xyuas zoo rau txhua tus tswv cuab ntawm Medi-Cal. QPHM suav nrog Pawg Saib Xyuas Kev Noj Qab Haus Huv Pej Xeem thiab Kev Ua Haujlwm Zoo thiab Kev Noj Qab Haus Huv Kev Ncaj Ncees.
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Population Health Management Division (PHMD)
PHMD oversees all population health efforts within DHCS, including CalAIM’s population health management and Enhanced Care Management to support member care coordination. PHMD oversees DHCS’ comprehensive plan to address member needs and preferences across the continuum of care.
Quality and Health Equity Division (QHED)
QHED oversees all DHCS health care clinical quality functions, leads health equity efforts, and coordinates with other areas within the Department, other state departments, county partners, and external stakeholders to achieve DHCS’ goal of equitable, high-quality care in Medi-Cal.
Office of Medicare Innovation and Integration (OMII)
OMII works to improve health outcomes, quality, affordability, and equity for Medicare members in California, consistent with the Governor’s Master Plan for Aging and CalAIM. OMII partners with teams across DHCS, other state agencies, and stakeholders. Key initiatives include CalAIM Dual Special Needs Plans and efforts to make Medicare enrollment more transparent, improve delivery systems, and increase access to long-term services and supports.
Office of Strategic Partnerships (OSP)
OSP ua tus thawj coj loj ntawm kev nqis tes ua ntawm Lub Tsev Haujlwm Saib Xyuas Kev Ncaj Ncees tsim kev sib raug zoo nrog cov neeg koom tes saib xyuas kev noj qab haus huv uas tsis yog ib txwm muaj, xws li Children and Youth Behavioral Health Initiative, CalHOPE, thiab CalAIM Justice-Involved Reentry Initiative. Lub Chaw Haujlwm ua haujlwm ncaj qha nrog cov neeg koom nrog, cov chaw muab kev pabcuam, cov nroog, cov phiaj xwm kev noj qab haus huv, kev tsim kho tshiab thiab kev pabcuam nyiaj txiag, lwm lub koomhaum hauv lub xeev, Lub Tsev Haujlwm Saib Xyuas Kevcai lij choj, thiab ntau lub koomhaum thoob plaws lub xeev.
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Administration provides various central support services to help achieve DHCS program and operations objectives. Administration’s services include human resources management, procurement and contracting services, facilities management, and emergency management. Administration includes the Human Resources, Procurement and Contracting, and Program Support Divisions.
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Human Resources Division (HRD)
HRD muab tag nrho cov peev txheej ntawm tib neeg cov kev pabcuam rau DHCS thiab tswj xyuas cov kev xaiv, kev nrhiav neeg ua haujlwm, kev faib tawm, kev tswj xyuas kev ua haujlwm, kev sib raug zoo ntawm kev ua haujlwm, sijhawm ua haujlwm, them nyiaj thiab cov txiaj ntsig, thiab cov kev pab cuam xiam oob qhab. HRD yog lub luag haujlwm rau kev koom tes nrog thiab ua raws li cov cai tsim los ntawm California Department of Human Resources (CalHR). HRD ua kom DHCS cov kev pab cuam ua raws li cov cai lij choj ntawm cov neeg ua haujlwm, cov cai, cov cai, thiab cov ntawv cog lus hauv tsev.
Kev Muag Khoom thiab Kev cog lus Division (PCD)
PCD tswj hwm tag nrho cov peev txheej ntawm kev yuav khoom, kev cog lus, thiab kev yuav khoom. Nws yog lub luag haujlwm rau kev npaj thiab kev tsim kho, thov kev sib tw, suav nrog Kev Thov Kev Pom Zoo / muab, thiab kev txhim kho thiab ua tiav ntawm IT thiab tsis yog IT daim ntawv cog lus thiab xaj xaj. PCD ua haujlwm nrog Lub Tsev Haujlwm Saib Xyuas Kev Pabcuam General (DGS) kom ua tiav cov kev pabcuam kev yuav khoom thiab kev cog lus.
Program Support Division (PSD)
PSD txhawb nqa DHCS cov kev pabcuam los ntawm kev tswj hwm cov chaw tswj hwm, kev tswj hwm xwm txheej ceev, kev noj qab haus huv thiab kev nyab xeeb, kev tswj cov khoom vaj khoom tsev, kev tswj cov ntaub ntawv, chaw xa ntawv, chaw nres tsheb thiab tsheb thauj mus los, kev tswj cov ntaub ntawv, kev rov ua dua tshiab thiab e-sustainability tswj, thiab kev tswj fleet. PSD ua haujlwm nrog Department of General Services (DGS) los txhawb DHCS cov kev pab txhawb nqa.
Kev Tshawb Fawb thiab Kev Tshawb Fawb (A&I)
A&I yog lub Tsev Haujlwm Saib Xyuas Kev Ncaj Ncees rau Medi-Cal, tiv thaiv thiab txhim kho kev ncaj ncees ntawm cov kev pabcuam kev noj qab haus huv uas tswj hwm los ntawm DHCS. A&I ua kev tshuaj xyuas nyiaj txiag thiab kev kho mob ntawm cov phiaj xwm kev noj qab haus huv thiab cov kws kho mob thiab txheeb xyuas thiab tshawb xyuas Medi-Cal tus kws kho mob thiab cov tswv cuab kev dag, pov tseg, thiab kev tsim txom. A&I suav nrog Daim Ntawv Cog Lus thiab Kev Sau Npe Sau Npe, Kev Ntsuam Xyuas Nyiaj Txiag - Tus Neeg Mob Hauv Tsev, Kev Tshuaj Xyuas Nyiaj Txiag - Tus Neeg Mob Sab Nraud thiab Kev Noj Qab Haus Huv, thiab Kev Tshawb Fawb Kev Tshawb Fawb.
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Daim Ntawv Cog Lus thiab Kev Sau Npe Sau Npe (CERD)
CERD ua lub xeev txoj cai kho mob thiab daim ntawv cog lus ua raws li kev tshuaj xyuas ntawm cov phiaj xwm kev noj qab haus huv, cov kws kho mob, thiab Tshuaj Kho Mob Medi-Cal Organized Delivery Systems.
Financial Review – Inpatient Division (FRID)
FRID conducts financial and compliance reviews and audits of Medi-Cal and other DHCS programs’ inpatient providers, including acute hospitals and long-term care facilities, to ensure payments to providers of services rendered to Medi-Cal members are valid, accurate, and comply with governing laws, regulations, and program policy.
Kev Tshawb Fawb Txog Nyiaj Txiag - Tus Neeg Mob Sab Nraud thiab Tus Cwj Pwm Kev Noj Qab Haus Huv (FROBHD)
FROBHD ua cov kev tshuaj xyuas nyiaj txiag thiab kev ua raws cai ntawm Medi-Cal thiab lwm yam DHCS cov kev pab cuam kho mob sab nraud thiab tus cwj pwm, suav nrog Tsoom Fwv Teb Chaws Saib Xyuas Kev Noj Qab Haus Huv, Cov Chaw Kho Mob Hauv Nroog, Cov Chaw Pabcuam Kev Kawm Hauv Zos, Kev Tswj Xyuas Tus Kheej, Kev Thauj Mus Los Thaum Muaj Xwm Ceev, thiab daim ntawv qhia txog tus nqi noj qab haus huv.
Kev Tshawb Fawb Kev Pom Kev
Lub Tsev Haujlwm Saib Xyuas Kev Tshawb Fawb ua haujlwm thoob plaws lub xeev Medi-Cal thiab lwm yam DHCS cov kev pab cuam kev dag, pov tseg, thiab kev tshawb nrhiav kev tsim txom, suav nrog kev dag ntxias cov ntaub ntawv, Medi-Cal kev dag tus xov tooj thiab cov lus tsis txaus siab, kev tshuaj xyuas, kev tshawb nrhiav kev dag ntxias, thiab kev tshawb nrhiav cov tswv cuab.
Enterprise Data and Information Management (EDIM)
EDIM yog lub koom haum pabcuam cov ntaub ntawv uas koom tes nrog txhua qhov kev pabcuam DHCS kom ua tau raws li lawv cov ntaub ntawv thiab cov ntaub ntawv xav tau. EDIM suav nrog Kev Tshawb Fawb Cov Ntaub Ntawv, Kev Tswj Xyuas Cov Ntaub Ntawv Kev Noj Qab Haus Huv, thiab Kev Qhia Qhia Cov Ntaub Ntawv.
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Data Analytics Division (DAD)
DAD, nrog rau Pawg Saib Xyuas Kev Noj Qab Haus Huv Kev Tswj Xyuas, muab kev coj noj coj ua thiab kev txhawb nqa hauv kev sau, kev tswj hwm, kev tshuaj xyuas, thiab kev tshaj tawm cov ntaub ntawv los txhawb kev xav tau kev pab cuam, ua haujlwm zoo rau cov tswv cuab, thiab txhim kho cov txiaj ntsig.
Health Information Management Division (HIMD)
HIMD, nrog rau Lub Chaw Haujlwm Saib Xyuas Cov Ntaub Ntawv, muab kev coj noj coj ua thiab kev txhawb nqa hauv kev sau, kev tswj hwm, kev tshuaj xyuas, thiab kev tshaj tawm cov ntaub ntawv los txhawb kev xav tau kev pab cuam, pab cov tswv cuab zoo dua, thiab txhim kho cov txiaj ntsig.
Program Data Reporting Division (PDRD)
PDRD yog tus tswj xyuas cov ntaub ntawv saib xyuas rau DHCS. Qhov kev faib tawm no ua rau cov ntaub ntawv ua haujlwm nrog DHCS cov kev pabcuam thiab kev faib tawm los tsim thiab xa cov ntaub ntawv kho mob muaj txiaj ntsig los ntawm kev npaj, kev tshuaj xyuas cov ntaub ntawv, thiab kev tshaj tawm. Nws tau txais kev thov los tsim cov dashboards, tej yaam num, rho tawm cov ntaub ntawv thiab tsim cov ntaub ntawv thiab cov ntaub ntawv, xa cov ntaub ntawv sau tseg thiab cov ntaub ntawv illustrations. Txhua qhov haujlwm ua tiav txhawb nqa DHCS, thiab cov kev pabcuam saib xyuas thiab kev soj ntsuam.
Enterprise Technology Services (ETS)
ETS tswj hwm lub Department-wide information technology (IT), suav nrog IT kev taw qhia, kev lag luam architecture, IT tswj, portfolio thiab project tswj, IT daim ntawv thov thiab infrastructure kev khiav hauj lwm, thiab modernization ntawm DHCS 'Medi-Cal Enterprise System. ETS suav nrog Kev Pabcuam Kev Lag Luam Kev Lag Luam, Kev Pabcuam Xov Xwm Technology, thiab Medi-Cal Enterprise Systems Modernization Divisions.
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Kev Ua Lag Luam Kev Lag Luam Technology Services Division (BOTSD)
BOTSD xa thiab tswj cov cuab yeej uas twb muaj lawm thiab tshiab uas txhawb cov tswv cuab, DHCS cov kev pab cuam, California Health & Human Services Agency, thiab lwm lub tuam tsev / chaw ua haujlwm hauv Lub Chaw Haujlwm. BOTSD ua kom muaj kev ua raws li lub xeev thiab tseemfwv txoj cai lij choj thiab kev cai lij choj hais txog kev siv cov ntaub ntawv thev naus laus zis thiab kev tiv thaiv cov ntaub ntawv hluav taws xob.
Information Technology Strategy Services Division (ITSSD)
ITSSD muab cov kev pabcuam hauv nruab nrab ntawm cov ntaub ntawv thev naus laus zis los ua kom tiav DHCS cov hom phiaj kev pabcuam los ntawm kev lag luam thiab thev naus laus zis thiab kev sib koom tes.
Medi-Cal Enterprise Systems Modernization Division (MESMD)
MESMD npaj thiab tswj kev hloov pauv ntawm Medi-Cal cov tshuab thev naus laus zis. MESMD qhia txog yav tom ntej lub xeev architecture, cov phiaj xwm, thiab kev tswj hwm rau yuav ua li cas cov thev naus laus zis niaj hnub yuav ua tiav.
Nyiaj txiag
Nyiaj txiag ua kom pom tseeb txog nyiaj txiag thiab kev lav phib xaub ntawm DHCS cov peev txheej thiab cov kev pab cuam los ntawm kev coj lub Department txoj kev kwv yees, kev siv nyiaj txiag, thiab kev tswj nyiaj txiag thiab kev tshaj tawm cov txheej txheem. Nyiaj txiag suav nrog Kev Tswj Nyiaj Txiag thiab Nyiaj Txiag Saib Xyuas Kev Lag Luam.
Kev faib
Financial Management Division (FMD)
FMD muab kev ncaj ncees nyiaj txiag, pob tshab, thiab kev lav phib xaub ntau dua $ 156 nphom txhua xyoo hauv tsoomfwv thiab lub xeev cov nyiaj txiag. Nws saib xyuas DHCS cov haujlwm nyiaj txiag, suav nrog kev txhim kho pob nyiaj txiag thiab kev tswj hwm thiab kev suav nyiaj thiab kev tshaj tawm.
Kev Lag Luam Kev Lag Luam (FFD)
FFD npaj cov ntaub ntawv ob zaug-ib xyoos thiab kev kwv yees nyiaj txiag rau Medi-Cal thiab Family Health cov kev pab cuam.
Office of Administration Hearings and Appeals (OAHA)
OAHA txiav txim plaub ntug txiav txim los ntawm Medi-Cal cov chaw muab kev pab cuam ntsig txog ntau yam ntawm DHCS kev nqis tes ua, xws li teeb meem tshwm sim los ntawm kev txheeb xyuas nyiaj txiag thiab tus nqi ntsuas; kev rov ua dua tshiab, ncua, lossis tshem tawm cov ntawv tso cai lossis ntawv pov thawj; kev soj ntsuam ntawm kev nplua nyiaj txiag; kev ncua ntawm Medi-Cal cov chaw muab kev pab; tsis kam lees daim ntawv thov kev tso npe rau Medi-Cal; thiab txiav tawm los ntawm kev koom nrog hauv Medi-Cal qhov kev pab cuam.
Txoj Haujlwm Kev Ua Haujlwm
Txoj Haujlwm Kev Ua Haujlwm ua rau DHCS khiav Medi-Cal thiab nws lwm cov kev pabcuam kev noj qab haus huv tau zoo thiab ua raws li tsoomfwv thiab lub xeev cov cai thiab cov cai. Txoj Haujlwm Kev Ua Haujlwm suav nrog California Medicaid Management Information System—Kev Ua Haujlwm, Kev Pabcuam Kev Khomob, Kev Pabcuam Rau Npe, thiab Pabcuam Thib Peb Lub Luag Haujlwm thiab Kev Pabcuam Rov Qab.
Kev faib
California Medicaid ManaGement Information System (CA-MMIS)—Kev Ua Haujlwm
CA-MMIS—Lub Chaw Haujlwm Saib Xyuas Kev Ua Haujlwm Saib Xyuas Medi-Cal thov kev them nyiaj uas ua haujlwm kwv yees li $ 20 nphom hauv kev them nyiaj rau ze li 200 lab Medi-Cal tus nqi-rau-kev pabcuam txhua xyoo thiab tswj hwm ntau tus neeg muag khoom lub luag haujlwm rau kev muab cov ntaub ntawv thev naus laus zis thiab kev pabcuam kev lag luam txhawb nqa. rau CA-MMIS.
Clinical Assurance Divisio N (CAD)
CAD muab kev tshuaj xyuas kev siv thiab saib xyuas cov kev pabcuam xa mus rau ntau dua 700,000 Medi-Cal tus nqi-rau-kev pabcuam cov tswvcuab (cov uas tsis nyob hauv cov phiaj xwm saib xyuas). CAD muab kev saib xyuas tom qab kev lees paub ntawm cov kev pabcuam hauv tsev kho mob hauv tsev kho mob uas siv cov cuab yeej thiab cov txheej txheem los txiav txim qhov tsim nyog kho mob rau cov hnub hauv tsev kho mob thiab cov kev pabcuam kom ua tau raws li Medi-Cal cov cai thiab muaj feem xyuam rau lub xeev thiab tsoomfwv cov cai. CAD kuj tseem muab kev tswj hwm kev siv tus nqi zoo los ntawm kev tshuaj xyuas thiab txiav txim siab thov kev tso cai kho mob rau qee cov txheej txheem kho mob, kev pabcuam, thiab tshuaj.
Chaw Muab Npe Rau Npe (PED)
PED cov ntxaij vab tshaus, tso npe kawm, saib xyuas, thiab rov ua ntawv pov thawj ze li ntawm 300,000 Medi-Cal cov kws kho mob uas muab kev pabcuam rau ntau dua 15 lab tus tswvcuab Medi-Cal. Nws tshuaj xyuas cov ntawv thov los ntawm thiab sib txuas lus nrog ntau dua 40 hom kev pabcuam sib txawv. Nws tseem npaj thiab xa cov kev cob qhia rau cov neeg koom tes sab hauv thiab cov neeg koom nrog sab nraud.
Third-Party Liability and Recovery Division (TPLRD)
TPLRD ua ntau yam kev rov qab los thiab zam cov nuj nqis kom paub tseeb tias qhov kev pab cuam Medi-Cal yog tus neeg them nqi ntawm qhov chaw kawg, xws li nrhiav nyiaj rov qab rau cov kev pabcuam los kho tus tswvcuab raug mob, rov them tus kws khomob ntau dua, sau se thiab nqi them, thiab saib xyuas lossis them rau lwm yam. kev pab them nqi kho mob.