Plaub Hlis Ntuj 1, 2025
Xov xwm tshaj plaws
DHCS Tshaj Tawm Tshaj Tawm Tshaj Tawm Txog Kev Tswj Xyuas Kev Noj Qab Haus Huv thiab Kev Pabcuam Hauv Zej Zos Peb Lub Hlis
On March 27, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report summarizing utilization data from July 2024 through September 2024. Key highlights from the report include:
- Kev loj hlob zoo ib yam: Txij li thaum ECM tau tsim tawm thaum Lub Ib Hlis 2022, 279,824 tus tswv cuab Medi-Cal tshwj xeeb tau ua tiav rau hauv cov txiaj ntsig ECM. Hauv lub quarter thib peb ntawm 2024 ib leeg, 143,188 tus tswv cuab tshwj xeeb tau nkag mus rau ECM cov txiaj ntsig, nce 13 feem pua los ntawm lub quarter thib ob ntawm 2024.
- Kev koom tes nrog cov tub ntxhais hluas: Hauv Q3 2024, 28,342 cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 21 xyoos tau txais cov txiaj ntsig ECM, ua rau 13 feem pua nce los ntawm Q2 2024.
- Kev Pabcuam Hauv Zej Zog: Kwv yees li 296,500 tus tswvcuab tshwj xeeb Medi-Cal tau siv Cov Kev Pabcuam Hauv Zej Zog, nrog ntau dua 754,000 tag nrho cov kev pabcuam xa tuaj. Hauv lub quarter thib peb ntawm 2024 ib leeg, 136,031 tus tswv cuab tshwj xeeb tau txais Kev Txhawb Zej Zog, nce 7.5 feem pua los ntawm peb lub hlis thib ob ntawm 2024.
- Kev nkag tau txais kev pabcuam ntxiv: Txog Q3 2024, ze li 90 feem pua ntawm Medi-Cal cov tswvcuab tau nkag mus rau yam tsawg kawg 10 ntawm 14 Cov Kev Pabcuam Hauv Zej Zog. Ntau tshaj 41 feem pua ntawm cov tswv cuab tau nkag mus rau tag nrho cov kev pabcuam.
- Cov kev pabcuam tseem ceeb tau siv: Ntau tshaj 61 feem pua ntawm cov tswvcuab siv Cov Kev Pabcuam Hauv Zej Zog tau nkag mus rau Cov Khoom Noj Khomob Khomob / Cov Khoom Noj Khomob Khomob, thiab kwv yees li 32 feem pua tau siv ib lossis ntau qhov kev pabcuam los ntawm Housing Trio (Housing Transition Navigation Services, Housing Tenancy and Sustaining Services, and Housing Deposits).
Daim ntawv tshaj tawm ECM thiab Kev Pab Txhawb Zej Zog qhov tseeb no qhia tau hais tias muaj kev nce ntxiv ntawm kev siv lub quarter dhau-lub hlis twg raws li cov neeg ntxiv ntawm kev tsom xam tau dhau los tsim nyog rau ECM thiab cov kev pabcuam hauv zej zog ntxiv muaj nyob hauv cov nroog thoob plaws lub xeev. DHCS cia siab tias yuav pom kev nce npe kawm ntau ntxiv thoob plaws ECM thiab Kev Txhawb Zej Zog hauv lub hlis thiab xyoo tom ntej. Xyoo 2025, DHCS yuav txhawb nqa thiab txhawb nqa qhov kev loj hlob no los ntawm kev nthuav dav ECM thiab Zej Zog Txhawb Kev Pabcuam Kev Saib Xyuas Kev Ua Haujlwm, kev koom tes nrog cov neeg muaj feem muaj zog, thiab kev tsim kho txoj cai.
Kev hloov kho tshiab
Cov neeg ua haujlwm noj qab haus huv hauv zej zog
Effective April 1, DHCS updated Medi-Cal’s existing Community Health Worker (CHW) policy to allow supervising Medi-Cal providers to bill for covered CHW services provided by CHWs using two new Healthcare Common Procedure Coding System (HCPCS) codes recently added by the Centers for Medicare & Medicaid Services (CMS). DHCS is updating this policy to allow CHWs to better address the economic and social conditions that influence Medi-Cal members and community health, such as food, housing, and transportation insecurities and access to essential utilities. DHCS’ updated CHW policy aims to more effectively support and promote improved health outcomes for Medi-Cal members by addressing needs affected by social drivers of health. DHCS also issued a State Plan Amendment Public Notice to set the rates for these two codes to 100 percent of the Medicare rate, pursuant to Welfare & Institutions Code Section 14105.25.
Additionally, on April 1, DHCS issued a statewide standing recommendation that all Medi-Cal members who meet defined eligibility criteria for receiving CHW services would benefit from CHW services. This standing recommendation, issued to improve access and reduce barriers to Medi-Cal members receiving and Medi-Cal providers rendering CHW services, is signed by Dr. Karen Mark, DHCS’ Medical Director for Policy and Evaluation. Consistent with existing policy, this standing recommendation authorizes CHWs to provide covered Medi-Cal CHW services, including health education, health navigation, screening and assessment, and individual support and advocacy.
Koom nrog peb pab neeg
DHCS tab tom nrhiav ib tus neeg muaj peev xwm thiab muaj kev txhawb siab los ua haujlwm xws li:
- Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state’s Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.
DHCS tseem ntiav rau nws cov ntawv cog lus, kev tshuaj xyuas, kev saib xyuas, kev tswj xyuas pej xeem kev noj qab haus huv, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
DHCS posts upcoming public meetings on the Calendar of Events.
Strong Start & Beyond Partner Webinar
On April 2, from 12 to 12:45 p.m. PDT, California Surgeon General Dr. Diana E. Ramos will host the next Strong Start & Beyond partner webinar on prevention to improve lifelong health. Strong Start & Beyond is a bold movement to reduce California’s maternal mortality rate by 50 percent by December 2026. By leveraging the state’s investments and partnerships, we can foster awareness, encourage active participation in health, and build access to resources for mothers, pregnant people, and their families. Joining Dr. Ramos are Dr. Erica Pan, California Department of Public Health Director and State Public Health Officer; Dr. Bernadette Lim, Founder and Executive Director of the Freedom Community Clinic; and Dr. Atul Nakhasi, Transformational Physician Executive. Please contact the Office of the California Surgeon General if you have any questions.
Consumer Focused Stakeholder Workgroup (CFSW)
On April 4, from 10 to 11:30 a.m. PDT, DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted by April 2 on the DHCS Consumer-Focused Stakeholder Workgroup webpage.
California Children’s Services (CCS) Advisory Group Meeting
On April 9, from 1 to 4 p.m. PDT, DHCS will host the CCS Advisory Group quarterly meeting (advance registration required). DHCS and the CCS Advisory Group partner to ensure children in the CCS/Whole Child Model (WCM) program receive appropriate and timely access to quality care. Agenda topics include updates on 2025 priorities, including the 2025 WCM expansion; county compliance, monitoring and oversight; and Medi-Cal Rx pediatric integration. Additional information and meeting details are available on the CCS Advisory Group webpage.
Doula Implementation Stakeholder Workgroup
On April 11, from 10 a.m. to 12 p.m. PDT, DHCS will host the next Doula Implementation Stakeholder Workgroup meeting, as required by Senate Bill 65 (Statutes of 2021, Chapter 449), to examine the implementation of the Medi-Cal doula benefit, in accordance with section 14132.24 of the Welfare and Institutions Code. The meeting will be held at 1501 Capitol Avenue, Sacramento, CA, and is open to the public. The link for this meeting will be available on the DHCS Doula Implementation Stakeholder Workgroup webpage. The workgroup will discuss ways to minimize barriers to doula services and continue discussions regarding the workgroup’s report to the Legislature, which must be posted on DHCS’ website by July 1, 2025.
Tiv thaiv Access to Health Care Act (PAHCA)-Stakeholder Advisory Committee (SAC)
On April 14, from 11:30 a.m. to 3:30 p.m. PDT, DHCS will host the PAHCA-SAC meeting (advance registration for online participation required) at 1700 K Street (first-floor conference room 17.1014), Sacramento. The committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). For general inquiries or to receive more information about meetings, please email DHCSPAHCA@dhcs.ca.gov.
Txoj Kev Kho Mob Ncauj Ncauj Qhia Kev Ua Haujlwm Pabcuam
On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Med-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.
Hauv Case Koj Tsis Tau Nws
DHCS tshaj tawm Opioid Siv Cov Khoom Siv Kho Mob Tsis Zoo
On March 25, DHCS awarded $800,000 to two Local Emergency Medical Service Agencies to foster low-barrier access to clinically proven opioid use disorder (OUD) treatment for patients in an emergency medical services (EMS) setting who are at risk of overdose and often do not have access to services in other settings. The grants—awarded through the Emergency Medical Services Buprenorphine Use Pilot Program (EMSBUP) to the Stanislaus County EMS Agency and Ventura County EMS Agency—will enable these two agencies to address substance use disorder as a treatable emergency condition, utilizing paramedics to identify and treat patients who would benefit from medications for addiction treatment (MAT). MAT is the use of medications in combination with counseling and behavioral therapies, which is effective in treating OUDs and helping some people sustain recovery.
Tam sim no Qhib: Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Kev Muaj Peev Xwm thiab Cov Txheej Txheem Hloov Kho, Kev nthuav dav, thiab Kev Txhim Kho (CITED) Daim Ntawv Thov Round 4
On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners, including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.
The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PDT on May 2, 2025. The guidance document and application are available on the PATH CITED webpage. Please send any questions to cited@ca-path.com.