Kaum Ob Hlis Ntuj 16 , 2024
Xov xwm tshaj plaws
CMS Approves California’s BH-CONNECT Initiative to Transform Behavioral Health Services
The Centers for Medicare & Medicaid Services (CMS) approved the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration. This transformative initiative will expand access to essential behavioral health services for Medi-Cal members with significant mental health and substance use needs. Key features of BH-CONNECT include:
- Kev nqis peev pab rau cov neeg ua haujlwm: Txhawb nqa $ 1.9 txhiab daus las muaj zog thiab muaj ntau yam kev coj noj coj ua kev noj qab haus huv uas suav nrog cov nyiaj pab kawm ntawv, cov nyiaj qiv nyiaj rov qab, kev txhawb nqa neeg ua haujlwm, chaw nyob thiab kev sib raug zoo, thiab kev txhim kho kev ua haujlwm. Txoj kev pib ua haujlwm yuav raug tswj hwm los ntawm Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Kev Nkag Nkag thiab Xov Xwm (HCAI).
- Transitional Rent Assistance: Provides up to six months of rental support, through a member’s managed care plan, for eligible Medi-Cal members transitioning from institutions, congregate settings, or homelessness. This support is crucial in stabilizing individuals during vulnerable periods, significantly reducing the risk of returning to institutional care or experiencing homelessness. Transitional rent will serve as a bridge to permanent housing for members who need it. For members with significant behavioral health needs, the Behavioral Health Transformation funding dedicated to Housing Interventions will provide permanent rental subsidies and housing following Transitional Rent, providing seamless continuity, and supporting members in achieving long-term housing stability.
- Kev them nyiaj yug rau Cov Me Nyuam thiab Cov Hluas: suav nrog cov nyiaj ua haujlwm los txhim kho kev nkag mus thiab cov txiaj ntsig rau cov tub ntxhais hluas koom nrog kev noj qab haus huv menyuam yaus tau txais kev pabcuam tshwj xeeb rau kev puas hlwb.
- Kev txhawb siab rau Lub Nroog: Txhawb nqa $ 1.9 billion Access, Reform, and Outcomes Incentive Program: Muab nqi zog rau lub nroog cov phiaj xwm kev noj qab haus huv rau kev txhim kho kev nkag mus, txo qhov tsis sib xws, thiab txhawb kev txhim kho tus cwj pwm kev noj qab haus huv.
- Kev Pabcuam Hauv Zej Zog Kev Hloov Mus Rau Hauv Zej Zog: Txhawb cov tswvcuab hloov pauv los ntawm cov chaw ua haujlwm mus sij hawm ntev kom ntseeg tau tias muaj kev saib xyuas txuas ntxiv thiab ua tiav kev sib koom ua ke hauv zej zog.
- Short-term Inpatient Psychiatric Care: Muab kev hloov pauv tshiab rau tsoomfwv Medi-Cal cov nyiaj pab rau kev kho mob puas siab puas ntsws nyob rau lub sijhawm luv luv uas tau muab rau hauv cov chaw kho mob hauv tsev kho mob thiab chaw nyob uas ua tau raws li tsoomfwv lub koomhaum rau cov kab mob puas hlwb.
Nyob rau tib lub sijhawm nrog kev siv nyiaj thiab zam kev tso cai tso cai ua ib feem ntawm Tshooj 1115 kev pom zoo, DHCS tab tom siv lwm yam ntawm BH-CONNECT kev ua qauv qhia uas tsis tas yuav tsum muaj cai ua qauv qhia Tshooj 1115, suav nrog:
- Medi-Cal kev pab them nqi rau kev coj ua pov thawj (EBP), suav nrog (muaj nyob hauv lub nroog xaiv):
- Assertive Community Treatment (ACT), ib qho kev qhia dav dav, hauv zej zog, kev sib koom ua haujlwm pab pawg ua qauv los pab cov tib neeg uas muaj kev puas siab puas ntsws loj tiv thaiv cov tsos mob ntawm lawv cov kev mob hlwb thiab txhim kho lossis kho cov kev txawj ua haujlwm hauv zej zog.
- Forensic ACT, ib qho kev pabcuam ACT tsim rau cov tib neeg uas koom nrog kev ncaj ncees.
- Coordinated Specialty Care for First Episode Psychosis, ib qho kev qhia dav dav, hauv zej zog, kev sib koom ua haujlwm pab pawg ua qauv los pab cov tib neeg daws cov tsos mob ntawm kev puas siab puas ntsws thaum ntxov thiab koom nrog hauv zej zog.
- Kev Tso Npe Rau Tus Kheej thiab Kev Txhawb Nqa Tus Qauv ntawm Kev Txhawb Kev Ua Haujlwm, cov kev pabcuam hauv zej zog thiab pab pawg uas pab cov tib neeg uas muaj tus cwj pwm noj qab haus huv los ua kom muaj kev ua haujlwm zoo thiab muaj txiaj ntsig hauv zej zog, suav nrog kev tau txais thiab / lossis tswj kev ua haujlwm sib tw.
- Cov Kev Pabcuam Kev Noj Qab Haus Huv Hauv Zej Zog, cov kev pabcuam tiv thaiv xa tawm los ntawm cov txheej txheem tshwj xeeb ntawm kev coj tus cwj pwm kev noj qab haus huv los ntawm cov tswvcuab hauv zej zog uas ntseeg siab muab kev qhia txog kev noj qab haus huv, kev tawm tswv yim, thiab kev pabcuam navigation los txhawb cov tswvcuab uas xav tau kev saib xyuas kev noj qab haus huv thiab cov peev txheej hauv zej zog los daws cov neeg tsav tsheb kev noj qab haus huv.
- Cov Kev Pabcuam Hauv Tsev, cov kev pabcuam muaj nyob rau hauv cov kev pabcuam khomob uas muab lub cev qhov chaw rau cov neeg nyob nrog kev noj qab haus huv tseem ceeb los tsim kev sib raug zoo, koom nrog kev ua haujlwm thiab kev kawm, thiab tau txais kev pabcuam txhawb nqa.
- Kev nthuav qhia ntawm Medi-Cal cov kev cai rau kev coj ua pov thawj (EBPs) rau cov menyuam yaus thiab cov hluas, suav nrog Kev Kho Mob Ntau Yam, Kev Kho Tsev Neeg Ua Haujlwm, Kev Kho Niam Txiv-Me Nyuam Kev Sib Raug Zoo, thiab Kev Ncaj Ncees Ncaj Ncees (ua tiav hauv xeev). Los ntawm kev muab cov lus qhia meej dua thiab cov kev xav tau kev pab them nqi kho mob rau cov EBPs no, BH-CONNECT lub hom phiaj los xyuas kom meej tias ntau tus menyuam yaus thiab cov hluas hauv California tau txais kev kho mob zoo.
- Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Cheeb Tsam Hauv Cheeb Tsam Hauv Cheeb Tsam Kev Pabcuam Kev Noj Qab Haus Huv nyob rau hauv cov phiaj xwm kev saib xyuas los saib xyuas thiab xa Cov Kev Pabcuam Kev Khomob, tuaj koom nrog Pabcuam Menyuam Yaus thiab Tsev Neeg lub rooj sib tham, xyuas kom cov kev pabcuam saib xyuas raug tswj hwm tau koom tes nrog lwm cov kev pabcuam, thiab ua ib qho kev nce ntxiv rau cov thawj coj saib xyuas yog tias lawv ntsib teebmeem kev ua haujlwm (ua haujlwm thoob plaws lub xeev).
- Cov Chaw Zoo Tshaj Plaws muab kev cob qhia thiab kev pab cuam rau kev coj tus cwj pwm kev noj qab haus huv thiab cov chaw muab kev pabcuam los txhawb kev ncaj ncees ntawm kev kho mob thiab kev xa khoom ntawm EBPs (ua tiav thoob lub xeev).
- Child welfare/specialty mental health kev sib koom ua ke thaum tus menyuam nkag mus rau kev noj qab haus huv (ua haujlwm thoob lub xeev).
This multi-billion-dollar initiative combines federal, state, and local investments to create a more robust, equitable behavioral health system that prioritizes community-based solutions. By reducing emergency department visits and institutional stays, BH-CONNECT will help Californians achieve stability and recovery while building a stronger workforce and infrastructure to support long-term improvements.
Stay tuned for further updates, including stakeholder engagement opportunities and additional program details. Visit the DHCS BH-CONNECT webpage for more information.
Additionally, CMS approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) section 1115 demonstration, effective through December 31, 2026. The CalAIM amendment expands the service duration and frequency criteria for several Community Supports, including Recuperative Care (Medical Respite) and Short-Term Post-Hospitalization Housing services, in alignment with CMS’ national policy, and makes other technical changes.
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 Managed Care Quality and Monitoring Division to lead compliance-related activities for the state’s Medi-Cal managed care plans. These activities include, but are not limited to, developing and implementing policies, establishing standard operating procedures, engaging in continual improvement efforts, providing technical assistance, and conducting risk analysis for managed care plan audit programs in partnership with DHCS’ Contract and Enrollment Review Division. Applications must be submitted by December 26.
DHCS tseem tab tom ntiav rau nws txoj cai tswjfwm kev noj qab haus huv, kev siv thev naus laus zis, 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
Long-Term Care (LTC) Kawm Series: Tswj Kev Pabcuam Kev Kho Mob rau LTC Cov Kws Kho Mob
On December 17, from 9 to 10:30 a.m. PST, DHCS will host the Managed Care Resources for LTC Providers session (advanced registration required) as part of its educational LTC Learning Series. This session is designed for providers working in skilled nursing facilities, subacute care facilities, and intermediate care facilities for the developmentally disabled. Topics include Medi-Cal eligibility and managed care plan enrollment, LTC authorizations, and managed care billing and payment. Additionally, the agenda includes an overview of newly developed resources that provide information and helpful tips on various managed care topics. The session will feature managed care plan guest speakers.
LTC Learning Series participants are encouraged to submit questions in advance when registering for the session or by emailing them to LTCtransition@dhcs.ca.gov. Additional details about the LTC Learning Series are available on the CalAIM LTC Carve-In transition webpage.
DHCS Lub Rooj Sib Tham Txog Kev Txom Nyem
DHCS aims to collaborate with communities across the state to promote harm reduction and low-barrier, patient-centered care within California’s substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno, Los Angeles, and San Diego counties in winter 2025. Register on the event website.
Hauv Case Koj Tsis Tau Nws
Hloov mus rau Medicare Tshooj Ib Daim Ntawv Pom Zoo Yuav
On January 1, 2025, California will become a Medicare Part A buy-in state, meaning eligible Medi-Cal members will receive Medicare Part A services for free if they are enrolled in Medicare Part B and they qualify for the Qualified Medicare Beneficiary (QMB) program. For these members, Medicare, instead of Medi-Cal, will provide primary coverage for hospitalizations and other inpatient benefits covered through Medicare Part A. California’s new Medicare Part A buy-in agreement with the federal Centers for Medicare & Medicaid Services will eliminate the conditional enrollment requirements for Medicare Part A at the Social Security Administration. As a Part A buy-in state, California can enroll eligible QMB members in Medicare Part A year-round through a streamlined enrollment process without any late enrollment penalties.
Muab Kev Nkag Mus thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Muaj Peev Xwm thiab Cov Khoom Siv Hluav Taws Xob, Kev Hloov, Kev nthuav dav, thiab Kev Txhim Kho (CITED) Round 4 Daim Ntawv Thov
Thaum Lub Ib Hlis 6, 2025, DHCS yuav qhib PATH CITED Round 4 daim ntawv thov qhov rai. PATH CITED teg num muab nyiaj txiag los tsim kom muaj peev xwm thiab kev tsim kho ntawm cov neeg koom tes hauv av, suav nrog cov koom haum hauv zej zog, tsev kho mob, cov koom haum hauv nroog, Pawg Neeg, thiab lwm yam, kom koom nrog Medi-Cal kom tiav. Hnub kawg rau kev thov rau CITED Round 4 nyiaj txiag yog 11:59 teev tsaus ntuj PST thaum Lub Peb Hlis 7, 2025. Cov koom haum txaus siab raug txhawb kom nkag mus rau daim ntawv teev npe thiab cov ntaub ntawv qhia los pab npaj lawv daim ntawv thov. Thov xa cov lus nug rau cited@ca-path.com.