DHCS Stakeholder News Update – May 6, 2022
Nyob zoo cov neeg muaj feem xyuam,
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom muab qhov hloov tshiab no 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.
DHCS Cov Neeg Ua Haujlwm Hloov Pauv
Thaum Lub Tsib Hlis 31, Kelly Pfeifer, Tus Lwm Thawj Coj Saib Xyuas Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv, yuav so haujlwm los ntawm lub xeev mus ua haujlwm rau lwm yam. Tau ze li ntawm peb lub xyoos, Kelly tau coj txoj kev txhim kho thiab kev siv cov kev hloov pauv, keeb kwm kev mob hlwb thiab kev siv tshuaj yeeb tsis zoo rau cov kev pab cuam thiab cov phiaj xwm, suav nrog hauv California Advancing and Innovating Medi-Cal (CalAIM) teg num, Behavioral Health Continuum Infrastructure Program (BHCIP), thiab Behavioral Health Modernization project.
Tyler Sadwith, Tus Pab Lwm Tus Thawj Coj rau Kev Noj Qab Haus Huv Tus Cwj Pwm, yuav ua tus Lwm Tus Thawj Coj Ua Haujlwm thaum Kelly tawm haujlwm.
BHCIP thiab Community Care Expansion Program Update
The 2021-22 California State Budget provided once-in-a-generation investments in infrastructure funding alongside significant new state and federal resources to address homelessness, support health care delivery reform, and strengthen the social safety net. Together these commitments will address historic gaps in the behavioral health continuum to meet growing demand for services and supports. Infrastructure resources, led by DHCS and the California Department of Social Services, will ensure care can be provided in the least-restrictive settings by creating a wide range of options, including outpatient alternatives, urgent care, peer respite, wellness centers, social rehabilitation models, and licensed community care facilities. A variety of care placements can provide a vital off-ramp from intensive behavioral health service settings and transition the most vulnerable Californians to community living, as well as provide housing options for older adults and people with disabilities. For more information about these programs, please visit the BHCIP webpage.
Medi-Cal Rx 180-Hnub Txoj Cai Hloov Hloov
When Medi-Cal Rx launched, a 180-day transition policy was implemented to reduce the impact of the transition on Medi-Cal beneficiaries by extending their previously approved prescriptions, with or without previously approved prior authorizations (PA), through July 1, 2022. Medi-Cal Rx will continue to use historical PA and claims data for the transition policy beyond July 1, 2022. DHCS and Magellan Medicaid Administration are evaluating the appropriate time to terminate this transition policy. Detailed information will be provided in the coming weeks. Stakeholders will be given 90 days’ notice prior to the end of the 180-day transition policy.
Population Health Management (PHM) Vendor Contract
On May 9, DHCS will release an Invitation for Proposal (IFP) for a PHM Service vendor, as part of the CalAIM initiative. DHCS intends to award the resulting contract by July 2022. This procurement solicits applications for the development, operation, and eventual turnover to DHCS of the PHM Service.
PHM Kev Pabcuam nrhiav kev hloov pauv tag nrho-tus neeg muab kev saib xyuas rau cov neeg tau txais txiaj ntsig Medi-Cal, thaum tswj hwm kev pheej hmoo thiab daws qhov tsis sib xws hauv kev saib xyuas thiab kev noj qab haus huv ntawm cov neeg tsav tsheb. Qhov Kev Pabcuam PHM yuav txhawb nqa cov neeg tau txais txiaj ntsig-kev pom zoo rau cov neeg koom tes ua lag luam (lub xeev cov tuam haujlwm thiab cov koom haum, cov koom tes hauv nroog, thiab lwm yam); cov koom tes hauv kev saib xyuas kev noj qab haus huv (tsev kho mob, chaw tu neeg mob, thiab lwm yam); thiab cov koom haum saib xyuas kev tswj hwm (county Drug Medi-Cal, Medicare Advantage, thiab lwm yam) nrog rau kev nkag mus rau cov ntaub ntawv kho mob thiab kev pab cuam uas tuaj yeem siv los pab txhim kho kev saib xyuas zoo.
DHCS anticipates that implementation of the PHM Service will contribute to the overall CalAIM goal of improving beneficiaries’ quality of life and health outcomes, aligned with Medi-Cal initiatives outlined in Assembly Bill 133 (Chapter 143, Statutes of 2021). More information about the PHM Service is available in the draft PHM Program and Service Roadmap. For questions or comments, please email CalAIM@dhcs.ca.gov.