Xov xwm tshaj plaws​​ 

Cov Chaw Saib Xyuas Kev Kawm Hauv Zos (LEA) Pom zoo los koom nrog CYBHI Cov Nqi Them Ntau Tus Nqi​​ 

On December 1, DHCS announced the first cohort of 47 LEAs (across 25 counties) approved to participate in the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule, which will launch in January 2024, and statewide provider network. As part of the CYBHI, DHCS is expanding access to school-based (or school-linked) behavioral health services provided to students at a school site. Specifically, DHCS, in collaboration with the Department of Managed Health Care and California Department of Insurance, is establishing a statewide multi-payer school-linked fee schedule to reimburse school-linked providers for the provision of specified outpatient mental health and substance use disorder services furnished to students 25 years of age or younger at a school site. A fee schedule establishes a scope of services (e.g., psychoeducation, screening/assessment, treatment, and care coordination services), identifies billing codes and rates, and specifies provider types eligible to bill for services. Under state law, Medi-Cal managed care plans (MCP), commercial health plans, and disability insurers are obligated to reimburse eligible school-linked providers, including LEAs (e.g., services performed by pupil personnel services credentialed practitioners) and school-linked affiliated community-based organizations.​​ 

Welfare and Institutions Code section 5961.4(b) authorizes DHCS to “develop and maintain a school-linked statewide provider network of school-site behavioral health counselors.” To develop the CYBHI fee schedule provider network, DHCS implemented an operational readiness review process for all interested county offices of education and LEAs. In determining LEA readiness for this cohort, DHCS considered a variety of factors, including, but not limited to, Medi-Cal enrollment, service delivery infrastructure and capacity building, data collection and documentation, and billing infrastructure. The 47 LEAs met readiness review requirements and will participate in a learning collaborative to inform state level policy and operational guidance for the CYBHI fee schedule program. Cohort 2 will launch in July 2024 and Cohort 3 in January 2025.​​ 

More information about the CYBHI fee schedule program is available on the Statewide Multi-Payer School-Linked Fee Schedule webpage.​​ 

 

Koom nrog peb pab neeg​​ 

DHCS tab tom ntiav. DHCS muaj cib fim rau:​​ 

• Chief of Fee-for-Service Rates Development within Health Care Financing to develop, interpret, and issue policy on Medi-Cal reimbursement methodologies for Medi-Cal fee-for-service non-institutional and long-term care services and provider fee programs, ensuring uniform application of federal and state laws and regulations. (Final filing date (FFD) is December 20)​​ 
• Chief of Capitated Rates Development within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal managed care plans. (FFD is December 19)​​ 
• Deputy Director of Enterprise Technology Services and Chief Information Officer to lead and manage Department-wide IT services. Responsible for managing all IT services, information security, enterprise projects, and strategic innovation efforts. (FFD is December 8)​​ 
• Deputy Chief Counsel in the Office of Legal Services to provide advice and counsel to the directorate, deputy director and chief counsel, and other deputy directors on legal policy litigation, federal policy, financial operations, and legislation. (FFD is December 4)​​  

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

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

Medi-Cal Adult Expansion Webinar​​ 

Thaum Lub Kaum Ob Hlis 4, thaum 11 teev sawv ntxov txog 12 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham ntawm cov neeg laus nthuav dav ntawm Medi-Cal (yuav tsum tau sau npe ua ntej) rau cov koom haum hauv zej zog, MCPs, cov kws kho mob, thiab lwm tus neeg muaj feem cuam tshuam, suav nrog cov neeg sawv cev rau cov neeg siv khoom, kev saib xyuas kev noj qab haus huv, kev pab kev cai lij choj, thiab cov neeg laus tuaj txawv teb chaws. DHCS yuav siv qhov kev nthuav dav no raws li Senate Bill 184 (Tshooj 47, Txoj Cai ntawm 2022) thaum Lub Ib Hlis 1, 2024. Thaum ua tiav, qhov kev nthuav dav yuav muab rau cov neeg laus hnub nyoog 26-49 xyoo nrog tag nrho cov txiaj ntsig Medi-Cal, tsis hais txog kev ua neeg xam xaj lossis kev nkag tebchaws, yog tias lawv ua tau raws li tag nrho lwm yam kev tsim nyog tau txais Medi-Cal.​​ 

The webinar, which will be live and interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.​​ 

Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Kev Ncaj Ncees-Involved Program Lub Sijhawm Ua Haujlwm​​ 

Thaum Lub Kaum Ob Hlis 4 thaum 12 teev tsaus ntuj, DHCS yuav tuav lub rooj sib tham tom ntej PATH Kev Ncaj Ncees-Involved Program virtual chaw ua haujlwm teev sijhawm rau Round 3 cov neeg tau txais txiaj ntsig (yuav tsum tau sau npe ua ntej). Cov sijhawm ua haujlwm yuav muaj nyob rau txhua hnub Monday thaum 12 teev tsaus ntuj txog rau lub Kaum Ob Hlis 18, 2023, los pab Round 3 cov koom haum, suav nrog kev txhawb nqa kev xa tawm cov phiaj xwm. Yog xav paub ntxiv, mus saib ntawm Kev Ncaj Ncees-Involved Program lub vev xaib.​​   

Kev Tshawb Fawb Txog Kev Nyuaj Siab thiab Lus Teb hauv Family Planning Webinar​​ 

Thaum Lub Kaum Ob Hlis 7, thaum 12 txog 1:30 teev tsaus ntuj, DHCS thiab Lub Chaw Tiv Thaiv California yuav tuav ib qho Kev Tshawb Fawb Txog Kev Nyuaj Siab thiab Kev Teb hauv Kev Npaj Tsev Neeg webinar (yuav tsum tau sau npe ua ntej). Kev raug mob, suav nrog cov kev paub tsis zoo rau menyuam yaus, kev tsim txom ntawm tus kheej, thiab kev ua phem rau kev sib deev, muaj kev cuam tshuam loj rau cov txiaj ntsig kev noj qab haus huv thiab muaj ntau ntawm cov neeg nrhiav kev pab npaj tsev neeg. Kev raug mob cuam tshuam rau kev sib deev thiab kev muaj menyuam, kev xeeb tub, thiab kev puas siab puas ntsws, ua rau nws tseem ceeb rau cov kws kho mob los daws kev raug mob thaum muab kev pab npaj tsev neeg.​​ 

Qhov webinar no yuav tham txog Kev Txhaum Cai thiab Kev Tiv Thaiv Kev Tshawb Fawb Txog Kev Nyuaj Siab, Kev Nyuaj Siab, thiab Lub Zog (TRIADS) thiab txoj hauv kev uas nws yuav pab tau rau cov kws kho mob npaj tsev neeg. Siv cov ntaub ntawv tshawb fawb, cov neeg nthuav qhia yuav piav qhia txog yuav ua li cas TRIADS lub hauv paus tsim lub hauv paus ntawm kev nkag siab, kev hwm, thiab kev khuv leej, yog li ua kom muaj kev koom tes hauv kev saib xyuas thiab txhim kho cov txiaj ntsig kev noj qab haus huv hauv cov neeg mob nrhiav kev pab npaj tsev neeg.​​ 

For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website at a later date.​​ 

PATH Collaborative Planning and Implementation (CPI) Qhov Zoo Tshaj Plaws Webinar​​ 

On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar, Relationship Building with Organizations in the California Advancing and Innovating Medi-Cal (CalAIM) Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing Enhanced Care Management (ECM) and Community Supports, increasing providers’ successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the PATH CPI webpage.​​ 

Qhia Kev Txhim Kho Dementia Experience (GUIDE) Model Webinar​​ 

On December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS’ Dementia Care Aware initiative, will host a webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware webpage.​​ 

CalAIM Population Health Management (PHM) Lub Rooj Sib Tham Pab Pawg​​ 

On December 11, from 10:30 a.m. to 12 p.m., DHCS will host a PHM Advisory Group meeting (advance registration required). This meeting will include a briefing on policy guidance for changes to the modified Population Needs Assessment (PNA). To support the success of the PHM Program and broader transformation efforts, DHCS is redesigning MCP requirements for developing a PNA, which has historically been MCPs’ primary mechanism for identifying the priority health and social needs of their members, including health disparities. A central component of DHCS’ approach is for MCPs to meaningfully participate on local health departments’ Community Health Assessments (LHD CHA)/Community Health Improvement Plans (CHIP) rather than complete a separate PNA focused solely on their own members’ data. This meeting will provide an overview of forthcoming PHM policy guidance for MCPs to participate in LHD CHA/CHIP processes.​​ 

DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and PHM Service. Members, which include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, will participate in advisory group meetings and provide real-time feedback and recommendations. The meetings are open to the public, and meeting information and materials will be available on the DHCS website. Stakeholders are encouraged to submit questions in advance of the webinar to PHMSection@dhcs.ca.gov.​​ 

CalAIM LTC Carve-In: Yuav Ua Li Cas Medi-Cal Tswj Kev Pabcuam Txhawb Nqa Subacute Care Facility thiab ICF/DD Cov Neeg Nyob Hauv Tsev Webinar​​ 

Thaum Lub Kaum Ob Hlis 15, DHCS yuav zoo li tuav ib qho kev kawm webinar ntawm CalAIM long-term care (LTC) carve-in (yuav tsum tau sau npe ua ntej). Lub hom phiaj ntawm qhov webinar no yog muab cov chaw saib xyuas subacute, cov chaw saib xyuas nruab nrab rau cov tsev neeg xiam oob qhab (ICF/DD) cov tsev, Cov Chaw Hauv Cheeb Tsam, thiab Medi-Cal MCPs nrog kev nkag siab txog cov cai tswjfwm, cov kev pabcuam, thiab cov txiaj ntsig muaj rau cov chaw saib xyuas subacute thiab ICF/DD cov neeg nyob hauv tsev nyob rau hauv kev saib xyuas hauv kev npaj rau lub Ib Hlis 1 2024. Cov ntsiab lus ntxiv txog webinars thiab carve-in muaj nyob rau ntawm CalAIM LTC Carve-In Transition webpage.​​  

ECM thiab Community Supports Healthcare Common Procedure Coding System (HCPCS) Coding Guidance Webinar​​ 

Thaum Lub Kaum Ob Hlis 18, thaum 11 teev sawv ntxov txog 12 teev tsaus ntuj, DHCS tab tom tuav lub webinar los muab cov ntsiab lus ntawm cov kev hloov tshiab tsis ntev los no rau ECM thiab Community Supports HCPCS Coding Guidance (yuav tsum tau sau npe ua ntej). DHCS tau pib tshaj tawm cov lus qhia hauv 2021 uas suav nrog HCPCS cov lej thiab cov kev hloov pauv uas yuav tsum tau siv los tshaj tawm thiab sau nqi rau ECM thiab Kev Pabcuam Zej Zog ntsib kev sib ntsib. Qhov no suav nrog cov ntaub ntawv ntsib uas ECM thiab Community Supports cov chaw muab kev pabcuam xa mus rau MCPs rau kev thov lossis kev them nqi, thiab MCPs xa mus rau DHCS los saib xyuas kev ua haujlwm thiab kev ncaj ncees. Raws li kev tawm tswv yim xa los ntawm cov neeg muaj feem cuam tshuam thoob plaws lub xyoo thaum ntxov ntawm ECM thiab Kev Txhawb Zej Zog Kev Ua Haujlwm, DHCS tau hloov kho cov lus qhia no txhawm rau nce qib ntawm cov ntaub ntawv thoob plaws lub xeev thiab yooj yim rau kev tswj hwm lub nra.​​ 

Tshwj xeeb tshaj yog, DHCS tau ntxiv ECM tshiab thiab Zej Zog Txhawb HCPCS cov lej / hloov pauv kev sib txuas thiab ua tiav cov kev xav tau uas MCPs yuav tsis xav tau lossis tso cai rau lawv cov neeg muab kev pabcuam los tshaj tawm cov lej lossis hloov kho rau ECM thiab Cov Kev Pabcuam Hauv Zej Zos tshaj li tau teev tseg los ntawm DHCS hauv kev taw qhia. Qhov webinar no yuav muab MCPs, ECM thiab Community Supports cov chaw muab kev pab, thiab lwm cov neeg muaj feem txaus siab rau lub sijhawm los kawm ntxiv thiab nug cov lus nug txog cov kev hloov tshiab uas tau ua rau ECM thiab Community Supports HCPCS coding guidance.​​ 

Hearing Aid Coverage for Children Program (HACCP) Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav​​ 

Thaum Lub Kaum Ob Hlis 19, thaum 12 txog 1 teev tsaus ntuj, DHCS yuav tuav HACCP webinar (yuav tsum tau sau npe ua ntej) los qhia cov ntaub ntawv rau cov kws kho mob los pab cov neeg mob me thiab lawv tsev neeg kom tau txais txiaj ntsig HACCP ntau tshaj plaws. Kev cob qhia yuav hais txog cov kev xav tau ntawm cov tsev neeg los thov kev pab them nqi thiab cov txheej txheem xa ntawv thov rau audiologists, otolaryngologists, kws kho mob, thiab lawv cov neeg ua haujlwm hauv chaw ua haujlwm. Yog xav paub ntxiv, thov mus saib hauv www.dhcs.ca.gov/haccp.​​ 

Hauv Case Koj Tsis Tau Nws​​ 

Lub Ib Hlis 2024 Medi-Cal MCP Kev Hloov Pauv​​ 

As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.
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