Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab qhov hloov tshiab ntawm kev txhim kho tseem ceeb ntawm DHCS cov kev pabcuam, nrog rau cov lus qhia ntsig txog COVID-19 kev noj qab haus huv rau pej xeem xwm txheej ceev (PHE).​​ 

Xov xwm tshaj plaws​​ 

Kev Tshaj Tawm Txog Kev Hloov Kho Cov Neeg Muaj Cai Lij Choj Ob Hlis​​ 

DHCS tab tom txhim kho nws cov neeg muaj feem cuam tshuam hloov tshiab thiab mus tom ntej yuav tshaj tawm cov xov xwm Stakeholder txhua lub lim tiam es tsis txhob hloov kho ob lub hlis. Qhov kev hloov pauv no yuav tso cai rau cov neeg muaj feem tau txais xov xwm raws sijhawm raws sijhawm ntau zaus.​​ 

ACEs Aware​​ 

Lub koom haum ACEs Aware tau tshaj tawm daim ntawv qhia txog cov ntaub ntawv tshiab txhua peb lub hlis uas qhia txog tus naj npawb ntawm kev tshuaj ntsuam menyuam yaus tsis zoo (ACE) uas tau ua rau cov menyuam yaus thiab cov neeg laus hauv California ntawm Lub Ib Hlis 1, 2020, thiab Cuaj Hlis 30, 2021. Cov ntaub ntawv qhia tau tias cov kws kho mob Medi-Cal - feem ntau yog cov kws kho mob menyuam yaus, tsev neeg, thiab cov kws tshaj lij kev noj qab haus huv - tau ua kwv yees li 987,500 qhov kev kuaj ACE ntawm ntau dua 793,000 tus neeg tau txais txiaj ntsig Medi-Cal tshwj xeeb.​​  

Daim ntawv tshaj tawm kuj taug qab tus naj npawb ntawm cov tswv cuab hauv pab pawg kho mob uas tau ua tiav kev cob qhia online "Becoming ACEs Aware in California" ntawm lub Kaum Ob Hlis 4, 2019, thiab Tsib Hlis 31, 2022. Cov ntaub ntawv qhia tau tias muaj ntau dua 23,400 tus tib neeg tau kawm ACEs Aware, thiab 11,900 tus ntawm lawv yog cov kws kho mob Medi-Cal uas tau txais daim ntawv pov thawj ACEs Aware thiab tsim nyog tau txais kev them nyiaj Medi-Cal rau kev ua qhov kev kuaj mob ACE.​​    

Behavioral Health Continuum Infrastructure Program (BHCIP) Hloov tshiab​​ 

DHCS tau tso cai los ntawm txoj cai lij choj xyoo 2021 los tsim BHCIP thiab muab $ 2.1 billion los tsim, yuav, thiab nthuav cov cuab yeej cuab tam thiab nqis peev rau hauv cov chaw tsim kho vaj tse thaum muaj xwm txheej ceev uas cuam tshuam nrog kev noj qab haus huv tus cwj pwm. Cov nyiaj txiag tau muab tso tawm los ntawm ntau qhov kev nthuav dav ntawm cov chaw kho mob kev coj cwj pwm, ntawm no yog qhov hloov tshiab ntawm cov kev sib tw tom ntej:​​ 

• BHCIP Round 4: Cov Me Nyuam thiab Cov Hluas​​ 

Round 4 focuses on children and youth ages 25 and younger, including pregnant and postpartum people and their children, children, and transition-age youth, as well as their families. All applicants must demonstrate how their infrastructure project will expand behavioral health services for this population exclusively. DHCS will award $480.5 million for children- and youth-focused behavioral health infrastructure projects in this fourth round of competitive grants. The deadline to submit applications for the Request for Application (RFA) for Round 4: Children and Youth is August 31, 2022. Applicants will be expected to demonstrate “project readiness”, as detailed in the posted RFA, and will be funded according to which of three pre-construction phases their project is in. Full project funding will be contingent upon completion of all three phases of development planning.​​ 

• BHCIP Round 5 thiab Round 6: Round 5 thiab 6 yog tam sim no nyob rau hauv cov theem npaj. Kev sib tham rau Round 5: Crisis Continuum yog teem rau lub Yim Hli 4, txij thaum 1 teev tsaus ntuj txog 2 teev tsaus ntuj, thiab muab lub sijhawm rau cov neeg thov tsim nyog los muab tswv yim ncaj qha rau DHCS los qhia rau BHCIP Round 5 kev npaj thiab kev siv. Round 5 mloog kev sau npe yuav tsum tau sau npe. Yog xav paub ntxiv txog BHCIP, thov mus saib hauv BHCIP qhov project website lossis email BHCIP@dhcs.ca.gov.​​ 

Dental Transformation Initiative​​ 

On August 1, DHCS will begin issuing final Dental Transformation Initiative (DTI) payments for specific domains. The Budget Act of 2022 included $30.2 million to make DTI payments in fiscal year (FY) 2022-23 and $1.5 million in FY 2023-24. The DTI consisted of four domains to improve dental health for Medi-Cal children by focusing on high-value care, improved access, and utilization of performance measures to drive delivery system reform.​​ 

Domain 1 compensated service office locations with incentive payments for select preventive services if the provider increased enrolled Medi-Cal beneficiary utilization. Domain 2 allowed participating Medi-Cal Dental providers to receive payments for providing services to enrolled Medi-Cal beneficiaries, ages 6 and under, for a bundled service that included a caries risk assessment, treatment plan, nutritional counseling, and motivational interviewing. Domain 3 provided annual incentive payments to service office locations that maintained continuity of care for enrolled Medi-Cal beneficiaries. Dental managed care plans are not offered these incentive payments given the inherent requirement that managed care delivery systems provide continuity of care for their covered populations.​​ 

Cov nqi them rau thaj tsam 1 thiab 2 yuav raug them rau txhua tus kws kho mob Medi-Cal Dental uas tsim nyog hauv lub xeev Medi-Cal Dental fee-for-service (FFS) kev xa khoom, suav nrog cov chaw kho mob uas tsim nyog (piv txwv li, Federally Qualified Health Centers, Rural Health Clinics, thiab Indian Health Services/Memorandum of Agreement Clinics (cov chaw kho mob hauv zej zog)), thiab hauv lub tsev kho mob Dental Managed Care hauv Sacramento thiab Los Angeles counties. Cov nyiaj them rau Domain 1 yuav raug muab rau lub lim tiam ntawm Lub Yim Hli 1, thiab cov nyiaj them rau Domain 2 yuav raug muab rau lub lim tiam ntawm Lub Yim Hli 8. Kev them nyiaj rau Domain 3 kuj tseem yuav raug them rau cov neeg muab kev pabcuam FFS thaum lub lim tiam ntawm Lub Yim Hli 1.​​ 

DHCS xav tias lub voj voog them nyiaj no yuav yog lub voj voog kawg rau Domains 1 thiab 2 thiab kev them nyiaj ntxiv rau Domain 3 yuav raug ua tiav rau lub Xya Hli 3, 2023. Yuav muaj ib daim ntawv tshaj tawm tshwj xeeb rau cov kws kho hniav (Special Provider Bulletin) tso tawm rau lub Xya Hli 29 ntawm lub vev xaib Medi-Cal Dental Provider Bulletin kom qhia rau cov kws kho mob paub.​​ 

Domain 4, Local Dental Pilot Projects (LDPP), addressed Domains 1-3 through local pilot programs aimed at specific demographics. The goals were to address one or more of the three domains through alternative programs and potentially use strategies focused on rural areas, including local case management initiatives and education partnerships. As of December 31, 2020, all 13 LDPPs concluded their operations and began their administrative closeout phase.​​ 

Heightened Scrutiny Settings Public Comment Sijhawm​​ 

Thaum Lub Xya Hli 29, DHCS tau tshaj tawm Cov Kev Pabcuam Hauv Tsev thiab Hauv Zej Zog (HCBS) Cov Cai Kawg rau lub sijhawm tawm tswv yim rau pej xeem 30 hnub. Qhov no suav nrog cov ntawv qhia luv luv rau 115 lub chaw pabcuam neeg laus thiab cov chaw pabcuam neeg laus uas tau txheeb xyuas kom muaj kev tshuaj xyuas ntau ntxiv los ntawm DHCS, thiab tom qab ntawd DHCS tau txiav txim siab kom ua tau raws li cov qauv cai kawg ntawm HCB Settings Rule.​​ 

Raws li cov cai kawg ntawm HCB Settings Rule, lub xeev yuav tsum txheeb xyuas cov chaw uas xav tias muaj cov yam ntxwv ntawm lub koom haum. Cov chaw no suav nrog cov: 1) hauv ib lub tsev kho mob pej xeem lossis ntiag tug uas muab kev kho mob hauv tsev kho mob; 2) ntawm thaj chaw ntawm, lossis nyob ib sab ntawm, ib lub tsev kho mob pej xeem; lossis 3) uas muaj qhov cuam tshuam ntawm kev cais cov tib neeg tau txais Medi-Cal cov kev pabcuam HCBS los ntawm zej zog dav dua. Cov txheej txheem kev tshuaj xyuas siab dua tsuas yog pib yog tias lub xeev txiav txim siab qhov chaw ntawd kov yeej qhov kev xav ntawm lub koom haum; yog li ntawd, txhua qhov chaw uas lub xeev muab rau Lub Chaw rau Medicare & Medicaid Services (CMS) rau kev tshuaj xyuas siab dua yog cov uas tau ua pov thawj tias lawv tsis yog lub koom haum.​​ 

Rau txhua qhov chaw teeb tsa, daim ntawv qhia luv luv piav qhia txog qhov chaw teeb tsa, vim li cas nws thiaj raug tshuaj xyuas ntau dua, thiab cov pov thawj muaj los txhawb DHCS qhov kev txiav txim siab tias qhov chaw teeb tsa ua tau raws li cov qauv cai kawg ntawm HCB Settings Rule muaj rau pej xeem tawm tswv yim txij lub Xya Hli 29 txog Lub Yim Hli 28.​​ 

Cov lus qhia rau kev xa cov lus tawm tswv yim rau pej xeem muaj nyob rau ntawm nplooj ntawv web DHCS HCBS Statewide Transition Plan. DHCS yuav sau cov ntaub ntawv no thiab hloov kho qhov kawg ntawm Txoj Kev Npaj Hloov Pauv Thoob Plaws Xeev rau lub sijhawm ntxiv rau pej xeem tawm tswv yim ua ntej xa mus rau CMS. DHCS txhawb kom cov neeg koom tes txuas ntxiv mus saib lub vev xaib kom tau cov ntaub ntawv ntxiv thiab xa email rau STP@dhcs.ca.gov yog tias muaj lus nug.​​ 

Monkeypox Update: Laboratory Billing​​ 

Thaum Lub Xya Hli 26, 2022, Pawg Neeg Sau Ntawv Txog Cov Lus Qhia Txog Kev Ua Haujlwm Tam Sim No (CPT) ntawm American Medical Association tau tsim thiab tso tawm cov lej CPT los ua kom yooj yim rau kev tshaj tawm txog kev kuaj mob orthopoxvirus thiab monkeypox uas tam sim no muaj nyob hauv Tebchaws Meskas, suav nrog cov lej rau kev kuaj mob hauv chaw kuaj mob:​​ 

• 87593: Kev kuaj kab mob los ntawm nucleic acid (DNA lossis RNA); orthopoxvirus (piv txwv li, kab mob monkeypox, cowpox virus, vaccinia virus), amplified probe technique, txhua.​​ 

This new code is currently not programmed for billing in FFS Medi-Cal. Medi-Cal will announce when the claims adjudication system is ready, and release additional instructions providers should use when billing for a monkeypox testing code. Until then, providers are advised to administer the test when medically indicated and hold the Medi-Cal claim submission until further notice.​​ 

Kev kuaj mob tau muaj ntau dua, nrog ntau lub chaw soj nstuam loj hauv kev lag luam, suav nrog Labcorp, Quest, Aegis, Mayo Clinic Labs, thiab Sonic Healthcare, muab kev kuaj mob. Kuj muaj kev kuaj mob los ntawm qee lub chaw soj ntsuam kev noj qab haus huv hauv zos. Tsis muaj nqi rau kev kuaj mob rau pej xeem, thiab kev kuaj mob rau kev lag luam yuav tsum tau them raws li tau hais los saum toj no. Lub sijhawm no, tsoomfwv tebchaws tau muab cov koob tshuaj tiv thaiv kab mob pob khaus liab rau California tsawg tsawg, thiab California Department of Public Health (CDPH) tab tom ua haujlwm nrog cov chaw haujlwm kev noj qab haus huv hauv zos kom muab cov koob tshuaj no.​​  

DHCS will continue to update and inform all Medi-Cal providers about testing and vaccinations related to monkeypox as guidance becomes available.​​ 

Both the CDPH and the Centers for Disease Control and Prevention websites provide further guidance on monkeypox symptoms, testing, treatment, and vaccination.​​ 

Daim Ntawv Thov Kev Pabcuam thiab Kev lees paub rau Kev Sau Npe (PAVE) Portal rau Cov Kws Kho Hniav​​ 

Thaum Lub Kaum Hli Ntuj hnub tim 31, DHCS yuav siv lub portal PAVE rau cov kws kho hniav. Lub PAVE portal yog ib daim ntawv thov hauv web uas tsim los kom yooj yim thiab ua kom cov txheej txheem sau npe sai dua. PAVE yuav muab ib txoj kev tshiab rau kev xa daim ntawv thov rau cov kws kho hniav thiab cov ntaub ntawv xav tau rau DHCS, tso cai rau cov neeg thov siv Daim Ntawv Thov Medi-Cal Provider e-Form. DHCS yuav tsis txais cov ntawv thov ua ntawv lawm thaum PAVE raug siv.​​ 

Dental providers are invited to attend an online demonstration. The two-part series will begin with an introduction to PAVE on August 24, and an overview of key features to be scheduled for October. A more in-depth training session will be scheduled for November, following the implementation of PAVE.  Each session is one hour. The demonstrations will be recorded and made accessible for future reference on the DHCS PAVE webpage. DHCS will release a Special Provider Bulletin by August 8 to notify providers about the upcoming trainings.​​   

Lub Xeev HCBS Gap Analysis thiab Multiyear Roadmap - Kev xaiv tus neeg cog lus​​ 

Thaum Lub Peb Hlis Ntuj xyoo 2022, DHCS tau tshaj tawm Daim Ntawv Thov Cov Ntaub Ntawv (RFI) thov cov ntaub ntawv los ntawm cov neeg txaus siab los pab DHCS hauv kev pib ua ib qho project loj los ua qhov kev tshuaj xyuas qhov sib txawv thoob plaws lub xeev thiab Multiyear Roadmap ntawm California cov kev pab cuam thiab network HCBS thiab Managed Medi-Cal Long-Term Supports and Services (MLTSS). DHCS tau txais ntau qhov kev sib tw, thiab los ntawm nws cov txheej txheem xaiv tsa muaj zog, txiav txim siab tias Mathematica yog qhov zoo tshaj plaws los ua kom tau raws li lub hom phiaj ntawm Money Follows the Person (MFP) Supplemental Funding - Gap Analysis thiab Multiyear Roadmap. DHCS npaj yuav ua kom tiav daim ntawv cog lus/Scope of Work nrog Mathematica thaum Lub Yim Hli, nrog rau tus neeg cog lus pib ua haujlwm tam sim ntawd tom qab ua tiav daim ntawv cog lus. Kev xa daim ntawv tshuaj xyuas qhov sib txawv yuav tshwm sim thaum lub Cuaj Hlis 30, 2023, thiab daim ntawv qhia kev ua haujlwm ntau xyoo yuav raug xa thaum lub Peb Hlis 31, 2024. DHCS yuav nthuav qhia cov khoom xa tuaj zaum kawg rau cov neeg koom nrog thiab cov neeg tsim cai lij choj thaum Lub Rau Hli 30, 2024.​​ 

Tshaj tawm cov ntaub ntawv COVID-19​​ 

• Hloov tshiab: Tus nqi txhaj tshuaj Medi-Cal COVID-19​​ 
• SPA 22-0037: Xaiv Kev Pabcuam Scope Hloov Kho​​ 

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

CalAIM Webinar thiab Chaw Ua Haujlwm Sijhawm: Txhim Kho Kev Tswj Xyuas (ECM) thiab Zej Zog Txhawb Kev Pabcuam Cov Ntaub Ntawv Sib Tham​​ 

On August 4, from 10:30 a.m. to 12 p.m., DHCS will host a webinar on data exchange necessary for ECM and Community Supports, intended especially for managed care plans (MCPs) and providers in counties where ECM launched in July 2022, but open to all as a refresher. DHCS will provide an overview of the guidance documents that were released last year and corresponding data flows, with a focus on the exchange of information that occurs between MCPs and ECM and Community Supports providers. The webinar is for ECM and Community Supports Providers, MCPs, and others engaged in the implementation of ECM and Community Supports.​​ 

There will be time reserved during the webinar for participant questions and answers, as well as a follow-up office hours session for further questions on August 11, from 2 p.m. to 3 p.m. Advance registration is required for the ECM webinar and the office hours session. Please email CalAIMECMILOS@dhcs.ca.gov with any questions.​​ 

Medi-Cal Consumer-Focused Stakeholder Workgroup (CFSW) Lub Rooj Sib Tham​​ 

Thaum Lub Yim Hli 5, DHCS yuav tuav lub rooj sib tham CFSW tom ntej los ntawm kev cob qhia hauv webinar. Cov ntaub ntawv ntxiv txog pawg neeg ua haujlwm muaj nyob rau ntawm CFSW nplooj ntawv web. Thov xa email rau DHCSCFSW@dhcs.ca.gov yog tias muaj lus nug.​​