April 8, 2024 – Stakeholder Update
Xov xwm tshaj plaws
DHCS Launches Health Equity Roadmap Initiative
DHCS tau tshaj tawm qhov kev pib ua Health Equity Roadmap, uas yog ib qho kev siv zog los qhia thiab txhawb nqa DHCS txoj haujlwm kom tshem tawm qhov tsis sib xws ntawm kev noj qab haus huv thiab txhawb nqa kev ncaj ncees ntawm kev noj qab haus huv rau cov tswv cuab Medi-Cal. Daim phiaj xwm kev sib luag ntawm kev noj qab haus huv sawv cev rau cov txheej txheem uas tau tsim ua ntu zus nrog cov tswv cuab Medi-Cal los tsim kom muaj lub kaw lus Medi-Cal sib luag dua uas muab cov kev xav tau ntawm cov tswv cuab tso ua ntej. Kauj ruam thawj zaug hauv cov txheej txheem no yog kev ncig xyuas mloog thoob plaws lub xeev, thaum lub sijhawm ntawd cov thawj coj DHCS thiab cov neeg koom tes hauv zej zog tau mloog cov kev paub ntawm cov tswv cuab Medi-Cal nrog Medi-Cal. Cov ntaub ntawv sau los ntawm cov kev sib tham no yuav qhia txog kev tsim kho ntawm DHCS Health Equity Roadmap uas yuav coj kev tsim kho thiab kev siv cov kev pab cuam DHCS yav tom ntej los txhawb kev ncaj ncees ntawm kev noj qab haus huv.
Tom qab cov kev mloog, DHCS yuav pib txheeb xyuas cov ntsiab lus sib xws uas tau hnov los ntawm cov tswv cuab thoob plaws lub xeev. DHCS yuav ua haujlwm nrog cov tswv cuab ntawm Medi-Cal, cov kws tshaj lij, cov neeg tawm tswv yim, cov neeg muab kev pabcuam, thiab cov neeg koom nrog kom ntseeg tau tias txhua lub suab thiab kev paub dhau los raug suav nrog hauv kev sib tham. Daim Ntawv Qhia Txog Kev Ncaj Ncees Hauv Kev Noj Qab Haus Huv, uas tau tsim thaum lub sijhawm tsim ua ke, yuav suav nrog cov tswv yim thiab cov lus qhia uas cov tswv cuab tau qhia rau peb los hloov Medi-Cal mus rau hauv ib lub txheej txheem kev kho mob uas ncaj ncees dua.
Yog tias koj muaj lus nug txog qhov kev pib ua Health Equity Roadmap, lossis yog xav paub ntxiv txog DHCS yuav ua li cas thiaj ua rau Medi-Cal muaj kev ncaj ncees dua, thov xa email rau HealthEquityRoadmap@dhcs.ca.gov.
Telehealth: Sib tham sib siv Dashboard thiab Tshaj Qhia
As part of an overall initiative aimed at monitoring telehealth utilization within Medi-Cal, DHCS released the first phase of its public-facing interactive Medi-Cal Telehealth Utilization Dashboard and companion Biennial Telehealth Utilization Report. Both the dashboard and report will help DHCS take a data-driven approach to evaluating telehealth policy. DHCS’ objective is to consistently provide a range of telehealth metrics and articulate telehealth data in a public-facing format that is easy to access and understand.
DHCS anticipates publishing the dashboard and report in two phases. Phase one includes eight measure sets of medical services data related to telehealth utilization. Phase two will expand the dashboard to include data sets related to mental health, the Drug Medi-Cal Organized Delivery System, and dental care. The dashboard is anticipated to be completed with all data sets in summer 2024 and will be updated annually thereafter.
To complement the dashboard, DHCS created the report, which provides an executive summary of Medi-Cal telehealth utilization, trends, and key takeaways. The report includes telehealth utilization data from 2019 to 2022. For more information, please visit the Medi-Cal & Telehealth webpage. Please email your questions to Medi-Cal_telehealth@dhcs.ca.gov.
Kev hloov kho tshiab
Child Health and Disability Prevention (CHDP) Program Transition
Senate Bill 184 (Chapter 47, Statutes of 2022) tau tso cai DHCS los txiav tawm CHDP qhov kev pab cuam thiab kev hloov pauv mus rau lwm lub Medi-Cal kev xa khoom los ntawm Lub Xya Hli 1, 2024. Qhov kev hloov pauv no ua kom yooj yim dua thiab ua kom yooj yim rau kev xa cov kev pabcuam rau cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 21 xyoos, ua raws li cov hom phiaj ntawm California Advancing and Innovating Medi-Cal (CalAIM) teg num. CalAIM txhim kho tus qauv kev saib xyuas thoob plaws Medi-Cal los ntawm kev sib sau cov dej num saib xyuas rau cov menyuam yaus thiab cov hluas nyob rau hauv Medi-Cal cov phiaj xwm tswj hwm kev saib xyuas (MCP).
CHDP Transition Plan tau tsim los ntawm kev koom tes nrog CHDP Program Transition Workgroup thiab nrog kev tawm tswv yim los ntawm CHDP cov neeg koom nrog thoob plaws lub xeev. Txoj kev hloov pauv khaws cia qhov kev tsim nyog tau txais kev tso npe tam sim no muaj los ntawm CHDP Gateway, cov haujlwm hauv qab CHDP Childhood Lead Poisoning Prevention Program, thiab Txoj Haujlwm Saib Xyuas Kev Noj Qab Haus Huv rau Cov Menyuam hauv Kev Pabcuam. Raws li Txoj Cai Kev Noj Qab Haus Huv thiab Kev Nyab Xeeb Ntu 124024, DHCS tau tshaj tawm hauv nws lub vev xaib ib tsab ntawv tshaj tawm uas tau lees paub tias txhua yam haujlwm uas xav tau rau kev hloov pauv tau ua tiav los ntawm Lub Peb Hlis 27, 2024.
Medi-Cal Rx
Thaum Lub Peb Hlis 29, daim ntawv tshaj tawm suav rov qab 30 hnub tau muab tso rau hauv Code 1 Diagnosis Requirement - Reject Code 80 claim utilization management (UM) edits rau cov tswv cuab hnub nyoog 22 xyoo thiab laus dua. Txij li lub Plaub Hlis 30, 2024, Medi-Cal Rx yuav siv cov lej kuaj mob los ntawm cov ntaub ntawv kho mob Medi-Cal ntawm tus tswv cuab kom ua tau raws li qhov kev txwv ntawm Code I. Yog tias tus lej kuaj mob uas lees txais tsis pom nyob rau hauv cov ntaub ntawv kho mob lossis suav nrog thaum lub sijhawm txiav txim siab thov, cov ntawv thov xa mus rau Medi-Cal Rx yuav tsis lees txais nrog Tus lej Tsis lees txais 80. Cov kev cai ntawm cov ntaub ntawv sau tshuaj siv rau cov tshuaj txwv tsis pub kuaj mob Tus lej I. Cov kws kho mob thiab cov kws muag tshuaj yuav tsum sau cov ntaub ntawv kuaj mob thiab khaws cov ntaub ntawv ntawd kom yooj yim rau kev tshuaj xyuas.
Koom nrog peb pab neeg
DHCS tab tom nrhiav neeg ua haujlwm rau kev sib txuas lus, kev pabcuam tib neeg, kev tshuaj xyuas, txoj cai kev noj qab haus huv, kev siv thev naus laus zis, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib lub vev xaib CalCareers.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
CalAIM Muab Kev Nkag Mus thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Technical Assistance (TA) Marketplace
Thaum Lub Plaub Hlis 9 thiab 25, txij 9 txog 10:30 sawv ntxov, DHCS yuav tuav lub rooj sib tham virtual CalAIM PATH TA Marketplace Vendor Fairs, qhov chaw uas cov neeg muag khoom nthuav qhia lawv lub koom haum thiab cov kev pabcuam rau cov neeg tau txais TA thiab txhawb kom siv TA Marketplace. Cov Neeg Tau Txais TA uas Tau Pom Zoo thiab cov koom haum uas tam sim no tau cog lus nrog lossis npaj yuav cog lus nrog Medi-Cal MCP lossis lwm lub koom haum tsim nyog los muab Kev Tswj Xyuas Kev Kho Mob Zoo Dua (ECM) / Kev Txhawb Nqa Hauv Zej Zog raug txhawb kom tuaj koom. Lub PATH TA Marketplace yog ib lub vev xaib uas muaj txhua yam koj xav tau los pab koj nrhiav cov kev pabcuam TA dawb los ntawm cov neeg muag khoom uas tau xaiv thiab pom zoo. Cov kev pabcuam muag khoom pab cov neeg muab kev pabcuam ECM/Community Supports uas tsim nyog los tsim lawv lub peev xwm ntawm cov ntaub ntawv, txhawb kev koom tes thoob plaws hauv kev lag luam, cob qhia cov neeg ua haujlwm tam sim no thiab cov neeg ua haujlwm tshiab, siv cov kev pabcuam uas teb tau lus, thiab ntau ntxiv.
Lub Rooj Muag Khoom Plaub Hlis 9 muaj cov neeg muag khoom muab kev pabcuam hauv Cheeb Tsam 2: Kev Txhawb Nqa Hauv Zej Zog thiab Cheeb Tsam 7: Cov Neeg Ua Haujlwm. Thaj Chaw 2 suav nrog cov neeg muag khoom TA uas muaj kev txawj ntse hauv kev tsim qauv, kev siv, thiab kev txhim kho ib lossis ntau qhov kev pabcuam Txhawb Nqa Hauv Zej Zog Medi-Cal. Thaj Chaw 7 suav nrog cov neeg muag khoom TA uas muaj kev txawj ntse hauv kev nrhiav neeg ua haujlwm thiab khaws cov neeg ua haujlwm uas tau npaj zoo, ua tau zoo, tshwj xeeb tshaj yog tsom mus rau cov tswv cuab ntawm cov neeg ua haujlwm pem hauv ntej, cov neeg ua haujlwm hauv chaw kho mob, thiab/lossis "cov neeg ua haujlwm uas tau muaj kev paub dhau los".
Lub Rooj Muag Khoom Muag Khoom rau lub Plaub Hlis 25 muaj cov muag khoom muab kev pabcuam hauv Cheeb Tsam 5: Kev Txhawb Kev Ncaj Ncees Kev Noj Qab Haus Huv thiab Cheeb Tsam 6: Kev Txhawb Nqa Kev Koom Tes Thoob Plaws Hauv Cheeb Tsam. Thaj Chaw 5 suav nrog cov neeg muag khoom TA uas muaj kev txawj ntse los pab cov neeg tau txais TA txhim kho kev ncaj ncees ntawm kev noj qab haus huv los ntawm lawv txoj kev siv ECM/Kev Txhawb Nqa Hauv Zej Zog thiab hauv lawv txoj haujlwm nrog cov tswv cuab Medi-Cal. Thaj Chaw 6 suav nrog cov neeg muag khoom TA uas muaj kev txawj ntse los pab cov neeg tau txais TA koom nrog kev sib koom tes hla kev lag luam, suav nrog kev sib koom tes ntawm Medi-Cal MCPs thiab cov nroog.
Tsis tas li ntawd xwb, thaum Lub Plaub Hlis 1, DHCS tau qhib daim ntawv thov muag khoom CalAIM PATH TA Marketplace Round 4. Cov koom haum uas xav thov kom tsim nyog ua tus muag khoom TA tuaj yeem thov ntawm nplooj ntawv web PATH TA Marketplace. Cov ntawv thov yuav tsum xa tuaj ua ntej 5 teev tsaus ntuj PDT rau lub Plaub Hlis 30. Cov neeg muag khoom uas tau pom zoo yuav tau txais cov nyiaj rov qab los ntawm PATH rau cov kev pabcuam TA uas lawv muab hauv TA Marketplace. Yog xav paub ntxiv, thov saib daim ntawv qhia.
California Children’s Services (CCS) Advisory Group Meeting
Lub Plaub Hlis 10, txij li 1 txog 4 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham CCS Pawg Pabcuam Peb Hlis. Pawg CCS Advisory Group thiab DHCS ua haujlwm hauv kev sib koom tes los xyuas kom cov menyuam yaus hauv CCS thiab Whole Child Model (WCM) kev pabcuam tau txais kev saib xyuas tsim nyog thiab sijhawm sijhawm. Cov txheej txheem txheej txheem suav nrog kev hloov kho tshiab ntawm WCM tom qab kev saib xyuas kev hloov pauv thiab nthuav dav, CCS Kev Ua Raws Cai, Kev Saib Xyuas, thiab Kev Saib Xyuas Kev Ua Haujlwm, Kev Tiv Thaiv Kev Noj Qab Haus Huv Me Me thiab Kev Tiv Thaiv Kev Xiam Oob Qhab, thiab CCS Redesign Performance Measure Quality Subcommittee. Cov ntaub ntawv ntxiv muaj nyob rau ntawm CCS Advisory Group lub vev xaib. Thov xa email rau koj cov lus nug rau CCSProgram@dhcs.ca.gov.
Doula Stakeholder Implementation Workgroup Meeting
Thaum Lub Plaub Hlis 12, txij 10 teev sawv ntxov txog 12 teev tav su, DHCS yuav tuav lub Rooj Sib Tham Ua Haujlwm Doula Stakeholder Implementation Workgroup tom ntej los tshuaj xyuas kev siv cov txiaj ntsig Medi-Cal doula, raws li Senate Bill 65 thiab Welfare and Institutions Code ntu 14132.24. Lub rooj sib tham yuav muaj nyob rau ntawm Zoom, nrog rau kev xaiv tus kheej ntawm 1501 Capitol Avenue, Sacramento, CA 95814, Chav 71.4003. Qhov txuas mus koom lub rooj sib tham hauv online nrog rau daim ntawv teev sijhawm muaj nyob rau ntawm Doula Services ua nplooj ntawv web Medi-Cal Benefit. Thov xa koj cov lus nug mus rau DoulaBenefit@dhcs.ca.gov.
Hauv Case Koj Tsis Tau Nws
DHCS Tshaj Tawm Daim Ntawv Qhia Txog Kev Ua Haujlwm Peb Hlis ntawm ECM thiab Kev Txhawb Zej Zog
Thaum Lub Plaub Hlis 4, DHCS tau tshaj tawm Daim Ntawv Qhia Txog Kev Siv ECM thiab Kev Txhawb Nqa Hauv Zej Zog uas muaj cov ntaub ntawv txij Lub Ib Hlis 2022 txog Lub Cuaj Hli 2023. Cov ntaub ntawv tso tawm no ntxiv cov ntaub ntawv siv rau peb lub hlis twg xyoo 2023 ntawm lub xeev, lub nroog, thiab Medi-Cal MCP theem thiab cov pej xeem, suav nrog haiv neeg, hom lus hais thawj, hnub nyoog, thiab poj niam txiv neej.
Daim ntawv qhia txog cov ntaub ntawv qhia txog kev nce ntxiv ntawm kev muaj thiab kev siv Cov Kev Txhawb Nqa Hauv Zej Zog, qhia txog kev loj hlob ntawm cov nroog uas muab cov kev pabcuam no. Txij li Lub Ib Hlis Ntuj xyoo 2024, muaj 23 lub nroog thoob plaws California tau muab tag nrho 14 qhov kev txhawb nqa hauv zej zog, thiab txhua lub nroog tau muab tsawg kawg yog xya qhov kev txhawb nqa hauv zej zog. Qhov no yog qhov nce ntxiv tseem ceeb los ntawm qhov kawg ntawm xyoo 2022, thaum tsuas muaj peb lub nroog muab tag nrho 14 qhov kev txhawb nqa hauv zej zog. Zuag qhia tag nrho, kwv yees li ntawm 103,000 tus tswv cuab Medi-Cal tshwj xeeb tau siv Kev Txhawb Nqa Hauv Zej Zog hauv 21 lub hlis thawj zaug ntawm qhov kev pab cuam, nrog rau ntau dua 186,000 qhov kev pabcuam tag nrho. Tsis tas li ntawd xwb, tus naj npawb ntawm cov tswv cuab uas ECM tau txais kev pab txhua lub quarter tau nce ntxiv; hauv Q3 2023, kwv yees li 86,000 tus tswv cuab tau txais ECM, nce 28 feem pua ntawm Q4 2022. Tag nrho Q3 2023 suav nrog 6,300 tus tswv cuab hnub nyoog qis dua 21 xyoo, ntau tus ntawm lawv tau tsim nyog rau ECM thaum Lub Xya Hli 2023. Tag nrho, ntau dua 160,000 tus tswv cuab Medi-Cal thoob plaws lub xeev tau txais ECM hauv 21 lub hlis thawj zaug ntawm qhov txiaj ntsig.
ECM thiab Kev Txhawb Nqa Hauv Zej Zog lub hom phiaj yog los txhim kho kev noj qab haus huv thiab kev nyob zoo ntawm cov tswv cuab Medi-Cal los ntawm kev daws teeb meem kev kho mob thiab kev sib raug zoo uas tuaj yeem cuam tshuam rau tus neeg txoj kev noj qab haus huv, suav nrog kev pab nyiaj txiag rau vaj tse, kev pab zaub mov, kev cob qhia ua haujlwm, thiab kev sib koom tes hauv nruab nrab ntawm kev saib xyuas. Yog koj muaj lus nug txog daim ntawv qhia no los yog xav muab tswv yim txog cov ntaub ntawv, thov email rau CalAIMECMILOS@dhcs.ca.gov.
Mobile Medi-Cal Dental Van Ncig saib
On April 4, DHCS kicked off the second mobile dental van tour in Fresno with a press event. DHCS’ Smile, California campaign informs Medi-Cal members about preventive dental services to children and youth to enhance utilization of essential dental care and improve oral health, particularly for underserved groups. In addition to Fresno, the mobile dental van visited Pixley (April 5) and will make future stops in Hollister (April 11), Avenal (April 12), and Huntington Park (May 4).
Cov tswv cuab ntawm Medi-Cal, cov kws kho mob thiab cov kws kho hniav, thiab cov koom haum hauv zej zog tuaj yeem kawm paub ntau ntxiv txog Medi-Cal cov kev pabcuam kho hniav uas tau them los ntawm kev mus saib lub vev xaib Smile, California, ua lus Askiv ntawm SmileCalifornia.org lossis ua lus Mev ntawm SonrieCalifornia.org. Lub vev xaib muaj cov peev txheej pab tau, xws li cov ntawv tshaj tawm qhia txog cov ntaub ntawv, cov yeeb yaj kiab, cov ntawv qhia txog qhov tseeb, thiab cov cuab yeej "Find-A-Dentist " los nrhiav tus kws kho hniav.