Xov xwm tshaj plaws

Medi-Cal Rov Ntxiv Cov Ntaub Ntawv Webinar

On August 7, from 3 to 4 p.m., DHCS will virtually host a webinar on the new DHCS continuous coverage unwinding data dashboard (advance registration required) to discuss data for June 2023 Medi-Cal renewals, the first month of California’s redeterminations since the end of the federal continuous coverage requirement on March 31. These data will include initial disenrollments from Medi-Cal eligibility renewals that occurred on July 1. Annual redeterminations will continue monthly, with the last eligibility renewal under the continuous coverage requirement occurring in May 2024, followed by a return to the normal annual renewal process.

BH-CONNECT thiab CalAIM Transitional Rent Services Public Hearing

On August 11, from 10 to 11:30 a.m., DHCS will host the first public hearing (advance registration required) to solicit stakeholder comments on the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration and proposed amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration related to transitional rent services. The public hearing will take place in person and have online video streaming and telephonic conference capabilities to ensure accessibility. Please view the “In Case You Missed It” section below for additional details on BH-CONNECT and CalAIM transitional rent services. Please email your questions to 1115Waiver@dhcs.ca.gov.

ECM thiab Zej Zog Txhawb Webinars   

DHCS will host two virtual webinars (advance registration required) for all stakeholders to provide an overview of the progress of Enhanced Care Management (ECM) and Community Supports implementation and to discuss important policy refinements and areas of reinforcement. The webinars will cover a range of topics, including eligibility, referrals and authorizations, provider networks, payment, market awareness, and data exchange. Key insights from the ECM and Community Supports calendar year 2022 implementation report will also be unveiled:

• ECM Tom Qab Xyoo Ib: Kev Txhim Kho Kev Ua Haujlwm thiab Kev Txhim Kho Txoj Cai, Lub Yim Hli 14, ntawm 2 txog 3 teev tsaus ntuj
• Kev Pabcuam Hauv Zej Zog Tom Qab Ib Xyoo: Kev Txhim Kho Kev Ua Haujlwm thiab Kev Txhim Kho Txoj Cai, Lub Yim Hli 18, thaum 9:30 txog 10:30 sawv ntxov

Yog xav paub ntxiv, mus saib nplooj ntawv web ECM thiab Community Supports. Yog koj muaj lus nug, thov email rau CalAIMECMILOS@dhcs.ca.gov.

Dental Managed Care (DMC) Thov Kev Pom Zoo (RFP)

On August 3, DHCS released the Medi-Cal DMC RFP for Sacramento and Los Angeles counties, with responses due no later than 4 p.m. on October 6, 2023. This contract will provide positive changes to the Medi-Cal DMC program. Recognizing the historical shortcomings of DMC plan performance, DHCS worked diligently to ensure there is a revised and comprehensive reform of California’s DMC contracts. DHCS is committed to improving Medi-Cal members’ oral health care delivery and experience—ensuring members have access to person-centered, equity-focused, and data-driven dental care. As a result, Medi-Cal’s DMC contracts will include:

• Qhov Kev Txhim Kho Zoo thiab Kev Hloov Pauv Kev Noj Qab Haus Huv Qhov Ncauj kom ntsuam xyuas thiab soj ntsuam kev ua tau zoo thiab kev coj ua ntawm DMC txoj kev npaj thiab tsim cov lus pom zoo thiab siv cov kev coj ua zoo tshaj plaws raws li txoj kev txhim kho zoo tas mus li. Muaj kev koom tes ntawm ntau theem ntawm txoj kev npaj, suav nrog cov tswv cuab Medi-Cal, cov tswv cuab ntawm pawg thawj coj saib xyuas txoj kev npaj, cov kev pab cuam kev noj qab haus huv hauv zos, thiab lwm yam. Qhov kev pab cuam no kuj tseem yuav koom nrog cov pawg neeg pab tswv yim hauv zej zog txog kev noj qab haus huv ntawm qhov ncauj los tsim thiab siv cov kev coj ua zoo tshaj plaws rau cov haujlwm ntawm DMC cov phiaj xwm.

• Kev lav ris thiab kev cog lus rau kev ua raws li txoj cai, suav nrog kev saib xyuas thiab kev saib xyuas cov chaw haujlwm tau muab cai. Lub hom phiaj yog kom ntseeg tau tias cov tswv cuab tau txais kev saib xyuas zoo thiab muaj kev nkag mus rau cov kev pabcuam sib npaug los ntawm kev ua raws li txoj cai, kev saib xyuas, thiab kev saib xyuas ntawm txhua lub koom haum uas tau muab txoj cai. Cov phiaj xwm DMC yuav raug lav ris txog qhov zoo ntawm kev saib xyuas ntawm txhua qib ntawm kev faib haujlwm. Qhov no yuav suav nrog kev piav qhia txog kev siv cov chaw ua haujlwm thiab cov neeg cog lus ua haujlwm kom ntseeg tau tias tus tswv cuab txoj kev paub thiab cov txiaj ntsig yog qhov tseem ceeb.
• Kev tsom mus rau kev koom ua ke kev kho mob thiab kev kho hniav. Cov kws kho mob muaj hwj chim los qhia cov tswv cuab txog cov kev pab tiv thaiv kev noj qab haus huv ntawm qhov ncauj, siv cov ntaub ntawv los saib xyuas qhov ua tau zoo ntawm txoj kev npaj DMC thiab txoj kev npaj kho mob. Cov tswv cuab yuav tau txais txiaj ntsig los ntawm kev sib koom tes kho mob thiab kev kho hniav ntawm kev ncav tes rau cov tswv cuab los ntawm ib txoj kev npaj mus rau ib tus tswv cuab thaum txoj kev npaj tau txais cov ntaub ntawv tias muaj kev mus ntsib chav kho mob ceev uas cuam tshuam txog kev noj qab haus huv ntawm qhov ncauj. Cov tswv cuab kuj tseem yuav tau txais cov ntaub ntawv ntxiv los pab lawv xaiv txoj kev npaj zoo tshaj plaws rau lawv tsev neeg thiab/lossis cov kev xav tau ntawm tus kheej. Cov phiaj xwm yuav tsum tau tshaj tawm rau pej xeem tsis tu ncua txog kev nkag mus, kev txhim kho zoo, thiab cov haujlwm ncaj ncees rau kev noj qab haus huv ntawm qhov ncauj, suav nrog kev ua tau zoo thiab kev txaus siab ntawm cov neeg siv khoom.

Tam sim no DHCS tau cog lus nrog peb lub phiaj xwm DMC hauv Los Angeles County raws li Prepaid Health Plan (PHP) thiab hauv Sacramento County raws li Geographic Managed Care (GMC). RFP yog rau DMC cov phiaj xwm txuas ntxiv ua haujlwm GMC hauv Sacramento County thiab PHP hauv Los Angeles County. Hnub npaj ua tiav daim ntawv cog lus rau RFP yog Lub Ib Hlis 2024, ua raws tam sim ntawd los ntawm pib lub sijhawm npaj daim ntawv cog lus. DHCS yuav teem ib tug capitated tus nqi rau cov ntawv cog lus ua hauj lwm lub sij hawm ntawm 54 lub hlis uas xav tias yuav pib rau lub yim hli ntuj 1, 2024.

Kev hloov kho tshiab

Children and Youth Behavioral Health Initiative (CYBHI) Nyiaj pab muaj

On August 7, DHCS will release a Request for Application (RFA) seeking proposals from various individuals, organizations, and agencies for the third round of grant funding, totaling $60 million, to scale evidence-based practices and community-defined evidence practices (EBP/CDEP) for early childhood wraparound services. The application deadline is October 6 at 5 p.m. Details are posted on the DHCS EBP/CDEP website.

Also, on July 31, the Mental Health Services Oversight and Accountability Commission (MHSOAC), in partnership with DHCS, released a separate RFA seeking proposals for the fourth round of grant funding, totaling $50 million, to scale youth-driven EBPs and CDEPs. MHSOAC will host a Bidders Conference webinar on August 9, from 11 a.m. to 12:30 p.m. to walk through the RFA and provide applicants the opportunity to ask questions about the procurement process and to obtain clarification on any component of the RFA. For this RFA, applications must be submitted electronically to the MHSOAC via e-mail to procurements@mhsoac.ca.gov by September 15 at 3 p.m. Please email any questions to procurements@mhsoac.ca.gov.

Yog koj muaj lus nug txog CYBHI EBP/CDEP cov nyiaj pab, thov hu rau DHCS ntawm CYBHI@dhcs.ca.gov. Yog xav paub ntxiv, thov mus saib DHCS lub vev xaib CYBHI, uas suav nrog CYBHI EBP/CDEP Grant Strategy uas qhia txog DHCS lub tswv yim dav dav los nthuav dav EBP/CDEPs thoob plaws ntau qhov kev pab nyiaj txiag.

Post Public Health Emergency (PHE) Txoj Cai Tshaj Tawm Txog Kev rho menyuam tawm tshuaj

Thaum Lub Yim Hli 1, DHCS tau hloov kho nws cov cai ntawm kev rho menyuam los ntawm tshuaj. Raws li txoj cai tshiab no, cov kws kho mob yuav tau txais nyiaj rov qab rau kev rho menyuam los ntawm kev siv tshuaj txog 77 hnub cev xeeb tub rau cov kev pabcuam uas tau muab rau lossis tom qab Lub Xya Hli 1. Ntxiv rau qhov ntawd, DHCS tau ua kom muaj kev ywj pheej mus tas li rau COVID-19, suav nrog cov uas tso cai rau kev siv cov qauv kev kho mob hauv xov tooj rau cov kev pabcuam yam tsis muaj kev txo nqi thaum muab kev rho menyuam. Yog xav paub ntxiv txog Medi-Cal cov cai rho menyuam, thov saib Phau Ntawv Qhia Txog Kev Rho Menyuam ntawm Medi-Cal thiab tsab xov xwm txog Kev Piav Qhia Txog Txoj Cai Rho Menyuam Tom Qab-PHE .

Population Health Management Initiative: Tsim lub Foundation Implementation Guide Series Tam sim no muaj

DHCS is pleased to share progress updates on the Population Health Management Initiative (PHMI), a California partnership between DHCS, Kaiser Permanente, and community health centers. The goal is that each participating community health center will focus on a common set of priority measures and specific populations, including children, pregnant people, people with behavioral health conditions, and adults living with chronic conditions and preventive care needs. The common set of priority measures directly align with the Federally Qualified Health Center (FQHC) Alternative Payment Methodology, which is a new payment system that seeks to transform the care provided through community health centers.

As of July 31, PHMI has launched the executive summaries of the Building the Foundation Implementation Guide series, which previews four implementation guides for primary care practices in California. These guides serve as an organized quality improvement strategy, with the goal of supporting substantive cultural, technological, and process changes that improve population-based care. The first version of these guides will be made available this fall.

For more information about PHMI, visit www.phminitiative.com. To receive quarterly newsletter updates about PHMI, sign up here.

Medi-Cal Rx

Thaum Lub Yim Hli 4, qhov kev rov qab los ua haujlwm tom ntej yuav tshwm sim. Theem IV, Lub Tshuab Nqa 1 yuav yog thawj lub tshuab nqa uas cuam tshuam rau kev tswj hwm kev siv cov ntaub ntawv thov rau cov tswv cuab hnub nyoog 22 xyoo thiab laus dua. Cov kev hloov kho rau daim ntawv thov yuav raug rov qab siv rau Khoom/Kev Pabcuam Tsis Them rau Hnub Nyoog ntawm Tus Neeg Mob, Khoom/Kev Pabcuam Tsis Them rau Txivneej/Pojniam ntawm Tus Neeg Mob, thiab Hom Tshuaj/Tus lej cim tshwj xeeb uas yuav tsum tau muaj. Cov chaw muab tshuaj kuj tseem yuav tau txais cov lus ntxiv nrog cov lej tsis lees txais.

Koom nrog peb pab neeg 

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

DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives. 

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

Health Enrollment Navigators Project Stakeholder Meeting

On August 7, from 1 to 2:30 pm, the DHCS Medi-Cal Health Enrollment Navigators Project will host their next quarterly stakeholder meeting. The Navigators Project team will provide updates on project activities. For more information, visit the Navigators Project website.

CYBHI Webinar

On August 7, from 2 to 3:30 p.m., DHCS will virtually host a CYBHI webinar (advance registration required) to keep stakeholders apprised of DHCS’ progress in implementing various CYBHI work streams and to share CYBHI updates, including a walkthrough of the EBP/CDEP Round 3 RFA. Key attendees include youth, parents, family members, behavioral health providers, Medi-Cal managed care plans, county behavioral health departments, commercial health plans, education, and other cross-sector partners.

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

On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff.

Hauv Case Koj Tsis Tau Nws

BH-CONNECT thiab CalAIM Transitional Rent Services

Thaum Lub Yim Hli 1, 2023, DHCS tau pib lub sijhawm 30-hnub kev tawm tswv yim rau pej xeem los thov cov lus tawm tswv yim ntawm Tshooj 1115 tshiab thov, hu ua BH-CONNECT ua qauv qhia. DHCS kuj tau pib 30-hnub lub sijhawm tawm tswv yim rau pej xeem los thov kev tawm tswv yim txog kev thov hloov kho rau CalAIM Tshooj 1115 ua qauv qhia ntsig txog cov kev pab cuam hloov pauv hloov pauv. Lub sijhawm tawm tswv yim rau pej xeem rau ob qho tib si yog txog lub Yim Hli 31, 2023.

BH-CONNECT Background

The BH-CONNECT demonstration builds upon unprecedented investments and policy transformations currently underway in California that are designed to expand access to community-based behavioral health care and improve outcomes for Medi-Cal members living with the most significant mental health and substance use needs. California has invested more than $10 billion and is implementing landmark policy reforms to strengthen the behavioral health care continuum. California’s proposed goal for the BH-CONNECT demonstration is to complement and amplify these major behavioral health initiatives to establish a robust continuum of community-based behavioral health care services and improve access, equity, and quality for Medi-Cal members living with SMI and SED, particularly populations experiencing disparities in behavioral health care and outcomes. The BH-CONNECT demonstration aims to expand Medi-Cal service coverage, drive performance improvement, and support fidelity implementation for key interventions proven to improve outcomes for Medi-Cal members experiencing the greatest inequities, including children and youth involved in child welfare, individuals with lived experience with the criminal justice system, and individuals at risk of or experiencing homelessness.

CALAIM Transitional Rent Amendment Background

Txhawm rau txhim kho kev noj qab haus huv thiab kev noj qab haus huv ntawm cov tswv cuab ntawm Medi-Cal thaum muaj kev hloov pauv tseem ceeb lossis uas ua tau raws li cov kev pheej hmoo siab, DHCS tab tom nrhiav kev hloov kho rau CalAIM Tshooj 1115 ua qauv qhia kom muab txog li rau lub hlis ntawm cov kev pab cuam hloov pauv hloov mus rau cov tib neeg tsim nyog uas tsis muaj tsev nyob lossis muaj kev pheej hmoo ntawm kev tsis muaj tsev nyob thiab kev hloov pauv ntawm cov chaw nyob, chaw zov me nyuam kom raug. Txoj kev noj qab haus huv, cov chaw saib xyuas rov qab los, tsev kho mob luv luv tom qab tsev kho mob, tsev nyob hloov pauv, cov tsev tsis muaj tsev nyob lossis cov tsev nyob ib ntus, nrog rau cov uas ua tau raws li cov txheej txheem rau kev tsis muaj vaj tse nyob los yog rau Kev Pabcuam Kev Sib Koom Tes (FSP). Cov kev hloov pauv hloov pauv yuav muaj nyob rau lub sijhawm tsis pub dhau rau lub hlis; yuav tsum tau them nyiaj; thiab yuav muab tsuas yog tias nws tau txiav txim siab kom tsim nyog kho mob siv kev kho mob thiab lwm yam kev xav tau ntawm kev noj qab haus huv. Medi-Cal cov kev pab cuam hloov pauv yuav yog kev yeem rau Medi-Cal cov phiaj xwm saib xyuas kev tswj hwm los muab thiab rau Medi-Cal cov tswv cuab siv.

Please visit the DHCS BH-CONNECT webpage and DHCS CalAIM 1115 Demonstration & 1915(b) Waiver webpage for background information, links to public comment materials, and information about how to provide feedback during the public comment period.

Smile, California Kev Sib Tw rau Medi-Cal Dental Services

On July 25, DHCS issued a news release in English and Spanish to promote the Sealants for a Healthy Smile (SHS) statewide push to encourage parents and guardians to protect their children’s dental health by utilizing their Medi-Cal Dental benefits and scheduling dental checkups for sealant applications. Subsequent stops of the mobile van tour will continue on August 11 in Trinity County, August 17-18 in Mono County, and August 29 in Colusa County. To reach and inform parents in the Central Valley, Smile, California partnered with Radio Bilingüe, a leading Latino public radio network, to run promotional programming through September.

To disseminate resources and information (fact sheet, infographic, and coloring sheet) to Medi-Cal members statewide, Smile, California outreach representatives are identifying and participating in in-person opportunities within their assigned regions during the promotion period. Representatives will assist with provider referrals, distribute relevant Smile, California resources, and promote Medi-Cal Dental covered services at community events, such as health fairs, parent nights, and back-to-school/open house events.